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Rohloff N, Rothenhöfer M, Götz T, Schäfer SD. Observational pilot study on the influence of an app-based self-management program on the quality of life of women with endometriosis. Arch Gynecol Obstet 2024:10.1007/s00404-024-07468-4. [PMID: 38869629 DOI: 10.1007/s00404-024-07468-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 03/10/2024] [Indexed: 06/14/2024]
Abstract
PURPOSE Endometriosis can significantly impair the quality of life of those affected. Multimodal self-help measures are recommended but often difficult to access. Smartphone apps have been shown to improve the quality of life for other conditions with chronic pain. The aim of this study was to examine whether there is evidence of beneficial effects of the smartphone app "Endo-App®" and whether a multicenter randomized controlled trial should be planned to substantiate these effects. METHODS In a sample of N = 106 women affected by endometriosis the present study determined the influence of the use of Endo-App® on their quality of life. Among others, the validated questionnaire Endometriosis Health Profile from Oxford University was used for this purpose. RESULTS The use of Endo-App® lead to a highly significant improvement in quality of life already after 2 weeks. A statistically significant change was found for nine out of ten measured variables of quality of life. A series of further analyses validated that the measured positive effects were not due to other confounding factors. CONCLUSION In summary, the results indicate that the quality of life of women with endometriosis improved by the digital self-management tool Endo-App®. More studies are needed to further explore the influence of the app on quality of life and as confirmatory evidence of beneficial effects. For this purpose, a randomized controlled trial should be conducted over a longer period of time. TRIAL REGISTRATION This trial is registered at clinicaltrials.gov under the registration number NCT05528601 on August 18, 2022. It was retrospectively registered.
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Affiliation(s)
- Nadine Rohloff
- Endo Health GmbH, Theaterstraße 56, 09111, Chemnitz, Germany
| | | | - Teresa Götz
- Endo Health GmbH, Theaterstraße 56, 09111, Chemnitz, Germany
| | - Sebastian Daniel Schäfer
- Department of Gynecology and Obstetrics, Clemenshospital Münster, Düesbergweg 124, 48153, Münster, Germany.
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Cheng YTD, Young KWD, Carlbring P, Ng YN, Hung SLS. A Pilot Randomized Controlled Trial Among People Recovering from Mental Illness: A Tailored Mindfulness-Based Intervention versus Relaxation Training. JOURNAL OF EVIDENCE-BASED SOCIAL WORK (2019) 2024; 21:318-348. [PMID: 37982391 DOI: 10.1080/26408066.2023.2281418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
BACKGROUND This study assessed the potential effectiveness, acceptability and feasibility of a tailored mindfulness-based intervention (MBI, REMIND 2.0) for personal recovery among people with mental illness during the COVID-19 pandemic. METHODS In this pilot mixed methods randomized controlled trial, participants were assigned to either the MBI (n = 14) or the relaxation training (RT) (n = 14). Quantitative measures were used to assess primary outcomes, including personal recovery, mindfulness, self-compassion, resilience, and secondary outcomes, including depression, stress, anxiety, positive and negative moods, quality of life and general health at baseline (T0), post-intervention (T1) and one-month follow-up (T2). Quantitative interviews were conducted to explore the experiences and perceptions toward the MBI. RESULTS Results indicated significant group and time interactions for all outcomes except anxiety and stress. MBI participants showed significant improvements in all outcomes at T1, which were maintained at T2, except for positive mood. RT participants showed a significant decline in resilience but significant improvements in all secondary outcomes at T1, but all outcomes significantly declined at T2, except for anxiety and stress. MBI participants were receptive toward the programme in all aspects of personal recovery. CONCLUSIONS The tailored MBI is a potentially effective, feasible and acceptable approach to facilitate personal recovery among people with mental illness. Differences between MBI and RT are discussed.
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Affiliation(s)
- Yi Ting Daphne Cheng
- Department of Social Work, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Kim Wan Daniel Young
- Department of Social Work, City University of Hong Kong, Kowloon Tong, Hong Kong
| | - Per Carlbring
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Yat Nam Ng
- Department of Social Work, Hong Kong Baptist University, Kowloon Tong, Hong Kong
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Hymowitz G, Hasan F, Yerramalli G, Cervoni C. Mindfulness-Based Interventions for Surgical Patients and Impact on Postoperative Outcomes, Patient Wellbeing, and Satisfaction. Am Surg 2024; 90:947-953. [PMID: 35940585 DOI: 10.1177/00031348221117025] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Several psychosocial factors can impact surgical outcomes and overall patient wellbeing following surgery. Although advances in surgical interventions and pain management protocols can reduce surgical trauma and enhance recovery from surgery, additional intervention is warranted to optimize surgical outcomes and patient quality of life (QoL) in the short- and long-term. Research on mindfulness techniques suggests that mindfulness-based interventions (MBI) effectively promote health behaviors, reduce pain, and improve psychological wellbeing and QoL. Thus, there has been an increase in research evaluating the use of MBIs to improve postoperative outcomes and wellbeing in surgical patients. The authors provide a brief overview of psychosocial outcomes of surgery and MBIs and review the literature on the impact of MBIs on postoperative outcomes. The extant literature indicates that MBIs are feasible and acceptable for use in surgical patient populations and provides preliminary evidence of the benefits of mindfulness across a range of surgical patient populations. However, more research is needed to assess the long-term efficacy of MBIs delivered online and in-person across the perioperative continuum.
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Affiliation(s)
| | - Farah Hasan
- Stony Brook University, Stony Brook, NY, USA
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Chen Q, Liu H, Du S. Effect of mindfulness-based interventions on people with prehypertension or hypertension: a systematic review and meta-analysis of randomized controlled trials. BMC Cardiovasc Disord 2024; 24:104. [PMID: 38350849 PMCID: PMC10865530 DOI: 10.1186/s12872-024-03746-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 01/22/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Hypertension and prehypertension have been widely recognized as the main contributors of global mortality. Evidence shows mindfulness-based interventions may reduce blood pressure and improve mental health. However, the effect of mindfulness-based interventions on blood pressure and mental health has not been fully understood. METHODS Potential studies published before May 24th 2023 were identified by searching Embase, Ovid Emcare, PsycINFO, CINAHL, Web of Science, Cochrane, PubMed, China National Knowledge Infrastructure, Wanfang database, and VIP China Science. Additionally, two grey databases were searched: Mednar, WorldWideScience.org. The risk of bias in the included studies was assessed using the Cochrane Risk of Bias Assessment tool. The random-effects meta-analyses were conducted using Review Man 5.4 software and the key outcomes are presented as mean difference or standard mean difference and the 95% confidential interval. RESULTS Searches returned 802 studies in total, of which 12 were included (N = 715). The duration of interventions was 8 weeks in 10 trials and 6 weeks in one trial. Pooled effect sizes indicated reductions in systolic blood pressure (MD = - 9.12, 95% CI [- 12.18, - 6.05], p < 0.001), diastolic blood pressure (MD = - 5.66, 95% CI [- 8.88, - 2.43], p < 0.001), anxiety (SMD = - 4.10; 95% CI [- 6.49, - 1.71], p < 0.001), depression (SMD = - 1.70, 95%CI [- 2.95, - 0.44], p < 0.001) and perceived stress (SMD = - 5.91, 95%CI [- 8.74, - 3.09], p < 0.001) at post-intervention. The findings from subgroup analyses are favorable for mindfulness-based interventions regardless of gender and baseline blood pressure with regard to BP reduction, with a more profound effect observed in participants with higher pre-intervention blood pressure. CONCLUSIONS The results provide evidence for the positive role of mindfulness-based interventions in hypertension management. More large randomized control trials with sufficient statistical power and long-term follow-up are needed. TRIAL REGISTRATION The protocol had been registered with Prospero on October 2nd 2021 (registration NO. CRD42021282504 ).
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Affiliation(s)
- Qiongshan Chen
- Shantou University Medical College, 22 Xinling Road, Jinping District, Shantou, Guangdong Province, 515041, China
| | - Hui Liu
- Department of Cardiology, The Second Affiliated Hospital of Shantou University Medical College, 69 Dongxia Road, Jinping District, Shantou, Guangdong Province, 515041, China.
| | - Shizheng Du
- School of Nursing, Nanjing University of Chinese Medicine, 138 Xianlin Avenue, Qixia District, Nanjing, Jiangsu Province, 210023, China
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Berko J, Mazonson P, Short D, Karris M, Ehui L, Gutner CA, Spinelli F, Zolopa A. Waitlist-controlled trial of an online intervention to address mental health among older people living with HIV. Antivir Ther 2023; 28:13596535231216311. [PMID: 38031911 DOI: 10.1177/13596535231216311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
Background: Older people living with HIV (PLWH) often experience elevated levels of depression, anxiety, and loneliness.Methods: This waitlist-controlled trial examined the effectiveness of online audio mindfulness lessons in impacting these feelings among older PLWH.Results: Among 214 participants, the mean (SD) age was 60.4 (5.9) years, 89% were male, and 69% were white. After 25 days, the intervention group showed significant improvements versus the waitlist control group in symptoms of depression (20.3% improvement, p < .01) and symptoms of anxiety (22.4% improvement, p = .03), but not in loneliness as measured by a Daily Diary (12.9% improvement, p = .07) or the 3-Item Loneliness Scale (4.8% improvement, p = .27). Secondary analyses among participants with elevated baseline symptoms of depression showed a 26.3% improvement (p < .01), with a moderate effect size (Hedge's g = 0.69). Similarly, those with elevated baseline symptoms of anxiety showed a 25.6% improvement (p < .01), a moderate effect size (g = 0.54), while those with moderate or severely elevated loneliness showed an 18.9% improvement in daily loneliness (p < .01), a moderate effect size (g = 0.55).Conclusion: This waitlist-controlled trial is the first to show that a series of brief, online audio mindfulness lessons improves mental health outcomes among older PLWH. For many patients, this intervention may offer relief that is both accessible and affordable.
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Affiliation(s)
- Jeff Berko
- Enhanced Health, Inc., Menlo Park, CA, USA
| | | | | | | | | | | | | | - Andrew Zolopa
- ViiV Healthcare, Raleigh, NC, USA
- Department of Medicine, Stanford University, Palo Alto, CA, USA
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Fritz JM, Greene T, Brennan GP, Minick K, Lane E, Wegener ST, Skolasky RL. Characterizing modifications to a comparative effectiveness research study: the OPTIMIZE trial-using the Framework for Reporting Adaptations and Modifications to Evidence-based Interventions (FRAME). Trials 2023; 24:137. [PMID: 36823645 PMCID: PMC9947905 DOI: 10.1186/s13063-023-07150-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 02/08/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND The OPTIMIZE trial is a multi-site, comparative effectiveness research (CER) study that uses a Sequential Multiple Assessment Randomized Trial (SMART) designed to examine the effectiveness of complex health interventions (cognitive behavioral therapy, physical therapy, and mindfulness) for adults with chronic low back pain. Modifications are anticipated when implementing complex interventions in CER. Disruptions due to COVID have created unanticipated challenges also requiring modifications. Recent methodologic standards for CER studies emphasize that fully characterizing modifications made is necessary to interpret and implement trial results. The purpose of this paper is to outline the modifications made to the OPTIMIZE trial using the Framework for Reporting Adaptations and Modifications to Evidence-Based Interventions (FRAME) to characterize modifications to the OPTIMIZE trial in response to the COVID pandemic and other challenges encountered. METHODS The FRAME outlines a strategy to identify and report modifications to evidence-based interventions or implementation strategies, whether planned or unplanned. We use the FRAME to characterize the process used to modify the aspects of the OPTIMIZE trial. Modifications were made to improve lower-than-anticipated rates of treatment initiation and COVID-related restrictions. Contextual modifications were made to permit telehealth delivery of treatments originally designed for in-person delivery. Training modifications were made with study personnel to provide more detailed information to potential participants, use motivational interviewing communication techniques to clarify potential participants' motivation and possible barriers to initiating treatment, and provide greater assistance with scheduling of assigned treatments. RESULTS Modifications were developed with input from the trial's patient and stakeholder advisory panels. The goals of the modifications were to improve trial feasibility without compromising the interventions' core functions. Modifications were approved by the study funder and the trial steering committee. CONCLUSIONS Full and transparent reporting of modifications to clinical trials, whether planned or unplanned, is critical for interpreting the trial's eventual results and considering future implementation efforts. TRIAL REGISTRATION ClinicalTrials.gov NCT03859713. Registered on March 1, 2019.
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Affiliation(s)
- Julie M. Fritz
- grid.223827.e0000 0001 2193 0096Department of Physical Therapy & Athletic Training, University of Utah, 383 Colorow Drive, Room 391, Salt Lake City, UT 84108 USA
| | - Tom Greene
- grid.223827.e0000 0001 2193 0096Department of Population Health Sciences, University of Utah, Salt Lake City, UT USA
| | - Gerard P. Brennan
- grid.420884.20000 0004 0460 774XRehabilitation Services, Intermountain Healthcare, Salt Lake City, UT USA
| | - Kate Minick
- grid.420884.20000 0004 0460 774XRehabilitation Services, Intermountain Healthcare, Salt Lake City, UT USA
| | - Elizabeth Lane
- grid.223827.e0000 0001 2193 0096Department of Physical Therapy & Athletic Training, University of Utah, 383 Colorow Drive, Room 391, Salt Lake City, UT 84108 USA
| | - Stephen T. Wegener
- grid.21107.350000 0001 2171 9311Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD USA
| | - Richard L. Skolasky
- grid.21107.350000 0001 2171 9311Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD USA ,grid.21107.350000 0001 2171 9311Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, MD USA
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Trépanier LC, Lamoureux É, Bjornson SE, Mackie C, Alberts NM, Gagnon MM. Smartphone apps for menstrual pain and symptom management: A scoping review. Internet Interv 2023; 31:100605. [PMID: 36761398 PMCID: PMC9905939 DOI: 10.1016/j.invent.2023.100605] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 11/25/2022] [Accepted: 01/27/2023] [Indexed: 01/31/2023] Open
Abstract
The past decade marks a surge in the development of mobile apps used to digitally track and monitor aspects of personal health, including menstruation. Despite a plethora of menstruation-related apps, pain and symptom management content available in apps has not been systematically examined. The objective of this study was to evaluate app characteristics, overall quality (i.e., engagement, functionality, design aesthetics, and information), nature and quality of pain and symptom tracking features, and availability and quality of pain-related intervention content. A scoping review of apps targeting facets of the menstrual experience was conducted by searching the Apple App Store. After removal of duplicates and screening, 119 apps targeting menstrual experiences were retained. Pain and menstrual symptoms tracking were available in 64 % of apps. Checkboxes or dichotomous (present/absent) reporting was the most common method of tracking symptoms and was available in 75 % of apps. Only a small subset (n = 13) of apps allowed for charting/graphing of pain symptoms across cycles. Fourteen percent of apps included healthcare professionals or researchers in their development and one app reported use of end-users. Overall app quality measured through the Mobile App Rating Scale (MARS) was found to be acceptable; however, the apps ability to impact pain and symptom management (e.g., impact on knowledge, awareness, behaviour change, etc.) was rated as low. Only 10 % of apps (n = 12) had interventions designed to manage pain. The findings suggest that despite pain and symptom management content being present in apps, this content is largely not evidence-based in nature. More research is needed to understand how pain and symptom management content can be integrated into apps to improve user experiences.
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Affiliation(s)
- Lindsey C.M. Trépanier
- Department of Psychology and Health Studies, University of Saskatchewan, Saskatoon, SK, Canada
| | | | - Sarah E. Bjornson
- Department of Psychology and Health Studies, University of Saskatchewan, Saskatoon, SK, Canada
| | - Cayley Mackie
- Department of Psychology and Health Studies, University of Saskatchewan, Saskatoon, SK, Canada
| | - Nicole M. Alberts
- Department of Psychology, Concordia University, Montréal, QC, Canada
| | - Michelle M. Gagnon
- Department of Psychology and Health Studies, University of Saskatchewan, Saskatoon, SK, Canada,Corresponding author at: University of Saskatchewan, Department of Psychology and Health Studies, 9 Campus Drive, Arts 154, Saskatoon, Saskatchewan, S7N 5A5, Canada.
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Sylvia LG, Gold AK, Rakhilin M, Amado S, Modrow MF, Albury EA, George N, Peters AT, Selvaggi CA, Horick N, Rabideau DJ, Dohse H, Tovey RE, Turner JA, Schopfer DW, Pletcher MJ, Katz D, Deckersbach T, Nierenberg AA. Healthy hearts healthy minds: A randomized trial of online interventions to improve physical activity. J Psychosom Res 2023; 164:111110. [PMID: 36525851 DOI: 10.1016/j.jpsychores.2022.111110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 11/27/2022] [Accepted: 11/27/2022] [Indexed: 12/03/2022]
Abstract
INTRODUCTION Depressed individuals are more likely to die from cardiovascular disease (CVD) than those without depression. People with CVD have higher rates of depression than those without and have higher mortality rates if they have comorbid depression. While physical activity (PA) improves both, few people engage in enough. We compared self-guided internet-based cognitive behavior therapy (CBT) + Fitbit or mindfulness-based cognitive therapy (MBCT) + Fitbit, with Fitbit only to increase daily steps for participants with depression who have low PA. METHODS Adult participants (N = 340) were recruited from two online patient-powered research networks and randomized to one of three study interventions for 8 weeks with an additional 8 weeks of follow-up. Using linear mixed effects models, we evaluated the effect of the intervention on average daily steps (NCT03373110). RESULTS Average daily steps increased 2.8 steps per day in MBCT+Fitbit, 2.9 steps/day in CBT + Fitbit, but decreased 8.2 steps/day in Fitbit Only. These changes were not statistically different between the MBCT+Fitbit and CBT + Fitbit groups, but were different from Fitbit Only across the initial 8-week period. Group differences were not maintained across follow-up. Exploratory analyses identified comorbid anxiety disorders, self-reported PA, and employment status as moderators. DISCUSSION Changes in daily steps over both 8- and 16-week periods-regardless of intervention group-were minimal. The results emphasize the limits of using self-guided web-based psychotherapy with an activity tracker to increase PA in participants with a history of depression and low PA.
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Affiliation(s)
- Louisa G Sylvia
- Dauten Family Center for Bipolar Treatment Innovation, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
| | - Alexandra K Gold
- Dauten Family Center for Bipolar Treatment Innovation, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Marina Rakhilin
- Dauten Family Center for Bipolar Treatment Innovation, Massachusetts General Hospital, Boston, MA, USA
| | - Selen Amado
- Dauten Family Center for Bipolar Treatment Innovation, Massachusetts General Hospital, Boston, MA, USA
| | | | - Evan A Albury
- Dauten Family Center for Bipolar Treatment Innovation, Massachusetts General Hospital, Boston, MA, USA
| | - Nevita George
- Dauten Family Center for Bipolar Treatment Innovation, Massachusetts General Hospital, Boston, MA, USA
| | - Amy T Peters
- Dauten Family Center for Bipolar Treatment Innovation, Massachusetts General Hospital, Boston, MA, USA
| | | | - Nora Horick
- Biostatistics, Massachusetts General Hospital, Boston, MA, USA
| | - Dustin J Rabideau
- Harvard Medical School, Boston, MA, USA; Biostatistics, Massachusetts General Hospital, Boston, MA, USA
| | - Heidi Dohse
- Dauten Family Center for Bipolar Treatment Innovation, Massachusetts General Hospital, Boston, MA, USA
| | - Roberta E Tovey
- Dauten Family Center for Bipolar Treatment Innovation, Massachusetts General Hospital, Boston, MA, USA
| | - Jon A Turner
- Department of Information, Operations, and Management Sciences, Stern School of Business, New York University, New York, New York, USA
| | | | - Mark J Pletcher
- University of California San Francisco, San Francisco, CA, USA
| | - Doug Katz
- Dauten Family Center for Bipolar Treatment Innovation, Massachusetts General Hospital, Boston, MA, USA
| | | | - Andrew A Nierenberg
- Dauten Family Center for Bipolar Treatment Innovation, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
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Mayol J. Technology, patients and value-based surgery. Cir Esp 2022; 100:745-746. [PMID: 35934237 DOI: 10.1016/j.cireng.2022.07.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 07/19/2022] [Indexed: 01/26/2023]
Affiliation(s)
- Julio Mayol
- Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos, Universidad Complutense de Madrid, Calle Martín-Lagos S/N, 28040 Madrid, Spain
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Tecnología, pacientes y cirugía basada en valor. Cir Esp 2022. [DOI: 10.1016/j.ciresp.2022.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Carli V, Petros NG, Hadlaczky G, Vitcheva T, Berchialla P, Bianchi S, Carletto S, Christinaki E, Citi L, Dinis S, Gentili C, Geraldes V, Giovinazzo L, Gonzalez-Martinez S, Meyer B, Ostacoli L, Ottaviano M, Ouakinin S, Papastylianou T, Paradiso R, Poli R, Rocha I, Settanta C, Scilingo EP, Valenza G. The NEVERMIND e-health system in the treatment of depressive symptoms among patients with severe somatic conditions: A multicentre, pragmatic randomised controlled trial. EClinicalMedicine 2022; 48:101423. [PMID: 35706482 PMCID: PMC9092507 DOI: 10.1016/j.eclinm.2022.101423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 04/08/2022] [Accepted: 04/11/2022] [Indexed: 11/17/2022] Open
Abstract
Background This study assessed the effectiveness of the NEVERMIND e-health system, consisting of a smart shirt and a mobile application with lifestyle behavioural advice, mindfulness-based therapy, and cognitive behavioural therapy, in reducing depressive symptoms among patients diagnosed with severe somatic conditions. Our hypothesis was that the system would significantly decrease the level of depressive symptoms in the intervention group compared to the control group. Methods This pragmatic, randomised controlled trial included 425 patients diagnosed with myocardial infarction, breast cancer, prostate cancer, kidney failure, or lower limb amputation. Participants were recruited from hospitals in Turin and Pisa (Italy), and Lisbon (Portugal), and were randomly assigned to either the NEVERMIND intervention or to the control group. Clinical interviews and structured questionnaires were administered at baseline, 12 weeks, and 24 weeks. The primary outcome was depressive symptoms at 12 weeks measured by the Beck Depression Inventory II (BDI-II). Intention-to-treat analyses included 425 participants, while the per-protocol analyses included 333 participants. This trial is registered in the German Clinical Trials Register, DRKS00013391. Findings Patients were recruited between Dec 4, 2017, and Dec 31, 2019, with 213 assigned to the intervention and 212 to the control group. The sample had a mean age of 59·41 years (SD=10·70), with 44·24% women. Those who used the NEVERMIND system had statistically significant lower depressive symptoms at the 12-week follow-up (mean difference=-3·03, p<0·001; 95% CI -4·45 to -1·62) compared with controls, with a clinically relevant effect size (Cohen's d=0·39). Interpretation The results of this study show that the NEVERMIND system is superior to standard care in reducing and preventing depressive symptoms among patients with the studied somatic conditions. Funding The NEVERMIND project received funding from the European Union's Horizon 2020 Research and Innovation Programme under grant agreement No. 689691.
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Affiliation(s)
- Vladimir Carli
- National Centre for Suicide Research and Prevention of Mental Ill-Health, Karolinska Institutet, Stockholm, Sweden
| | - Nuhamin Gebrewold Petros
- National Centre for Suicide Research and Prevention of Mental Ill-Health, Karolinska Institutet, Stockholm, Sweden
| | - Gergö Hadlaczky
- National Centre for Suicide Research and Prevention of Mental Ill-Health, Karolinska Institutet, Stockholm, Sweden
| | - Tereza Vitcheva
- National Centre for Suicide Research and Prevention of Mental Ill-Health, Karolinska Institutet, Stockholm, Sweden
| | - Paola Berchialla
- Department of Clinical and Biological Sciences, Università degli Studi di Torino, Turin, Italy
| | - Silvia Bianchi
- Research Center "E.Piaggio" and Department of Information Engineering, School of Engineering, Università di Pisa, Pisa, Italy
| | - Sara Carletto
- Department of Neuroscience "Rita Levi Montalcini", Università degli Studi di Torino, Turin, Italy
| | - Eirini Christinaki
- School of Computer Science and Electronic Engineering, University of Essex, Colchester, UK
| | - Luca Citi
- School of Computer Science and Electronic Engineering, University of Essex, Colchester, UK
| | - Sérgio Dinis
- Faculdade de Medicina and CCUL, Universidade de Lisboa, Lisbon, Portugal
| | - Claudio Gentili
- General Psychology Department, Università degli Studi di Padova, Padua, Italy
| | - Vera Geraldes
- Faculdade de Medicina and CCUL, Universidade de Lisboa, Lisbon, Portugal
| | - Lorena Giovinazzo
- Department of Clinical and Biological Sciences, Università degli Studi di Torino, Turin, Italy
| | | | | | - Luca Ostacoli
- Department of Clinical and Biological Sciences, Università degli Studi di Torino, Turin, Italy
| | - Manuel Ottaviano
- Life Supporting Technologies, Universidad Politécnica de Madrid, Madrid, Spain
| | - Silvia Ouakinin
- Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Tasos Papastylianou
- School of Computer Science and Electronic Engineering, University of Essex, Colchester, UK
| | | | - Riccardo Poli
- School of Computer Science and Electronic Engineering, University of Essex, Colchester, UK
| | - Isabel Rocha
- Faculdade de Medicina and CCUL, Universidade de Lisboa, Lisbon, Portugal
| | - Carmen Settanta
- Department of Clinical and Biological Sciences, Università degli Studi di Torino, Turin, Italy
| | - Enzo Pasquale Scilingo
- Research Center "E.Piaggio" and Department of Information Engineering, School of Engineering, Università di Pisa, Pisa, Italy
| | - Gaetano Valenza
- Research Center "E.Piaggio" and Department of Information Engineering, School of Engineering, Università di Pisa, Pisa, Italy
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How Does Buddhist Contemplative Space Facilitate the Practice of Mindfulness? RELIGIONS 2022. [DOI: 10.3390/rel13050437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
This paper examines the spaces where Buddhist spiritual activity—specifically mindfulness practice—takes place, exploring how contemporary urban Buddhist contemplative places may benefit people’s mindful experience. Historical Buddhist contemplative places are examined through a literature review of Buddhist philosophy and Buddhist architecture and landscape. A case study of Kagyu Samye Dzong London, UK (KSDL) in the contemporary western context is then presented, drawing upon mixed methods (qualitative spatial analysis, questionnaires with mindfulness practitioners, and an in-depth interview with the director of the Buddhist center). This study investigates the relationship between the Buddhist spiritual activity of mindfulness practice and one specific physical space, exploring how the KSDL has been designed and is used to facilitate such mindfulness awareness and insight. Results suggest that quiet, solitude, and the presence of nature are three tangible spatial qualities that can facilitate mindful practice to some extent. However, additional relational or intangible qualities, namely the presence of The Three Jewels and blessings, are equally if not more important when sustaining mindfulness for Buddhist practitioners, and these contemplative qualities are more than “spatial”. Both the physical tangible qualities and intangible qualities are indispensable in the contemplative space and in influencing one’s practice. Findings evidence the importance of physical design and space for supporting contemporary mindfulness practitioners, whilst acknowledging that mindfulness emanates from—and can ultimately be discovered from—within.
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Philippe TJ, Sikder N, Jackson A, Koblanski ME, Liow E, Pilarinos A, Vasarhelyi K. Digital Health Interventions for Delivery of Mental Health Care: Systematic and Comprehensive Meta-Review. JMIR Ment Health 2022; 9:e35159. [PMID: 35551058 PMCID: PMC9109782 DOI: 10.2196/35159] [Citation(s) in RCA: 56] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 02/28/2022] [Accepted: 03/02/2022] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has shifted mental health care delivery to digital platforms, videoconferencing, and other mobile communications. However, existing reviews of digital health interventions are narrow in scope and focus on a limited number of mental health conditions. OBJECTIVE To address this gap, we conducted a comprehensive systematic meta-review of the literature to assess the state of digital health interventions for the treatment of mental health conditions. METHODS We searched MEDLINE for secondary literature published between 2010 and 2021 on the use, efficacy, and appropriateness of digital health interventions for the delivery of mental health care. RESULTS Of the 3022 records identified, 466 proceeded to full-text review and 304 met the criteria for inclusion in this study. A majority (52%) of research involved the treatment of substance use disorders, 29% focused on mood, anxiety, and traumatic stress disorders, and >5% for each remaining mental health conditions. Synchronous and asynchronous communication, computerized therapy, and cognitive training appear to be effective but require further examination in understudied mental health conditions. Similarly, virtual reality, mobile apps, social media platforms, and web-based forums are novel technologies that have the potential to improve mental health but require higher quality evidence. CONCLUSIONS Digital health interventions offer promise in the treatment of mental health conditions. In the context of the COVID-19 pandemic, digital health interventions provide a safer alternative to face-to-face treatment. However, further research on the applications of digital interventions in understudied mental health conditions is needed. Additionally, evidence is needed on the effectiveness and appropriateness of digital health tools for patients who are marginalized and may lack access to digital health interventions.
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Affiliation(s)
- Tristan J Philippe
- Department of Cellular & Physiological Sciences, The University of British Columbia, Vancouver, BC, Canada.,Department of Psychiatry, The University of British Columbia, Vancouver, BC, Canada
| | | | - Anna Jackson
- School of Social Work, The University of British Columbia, Vancouver, BC, Canada
| | - Maya E Koblanski
- Department of Cellular & Physiological Sciences, The University of British Columbia, Vancouver, BC, Canada.,Department of Psychology, The University of British Columbia, Vancouver, BC, Canada
| | - Eric Liow
- Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| | - Andreas Pilarinos
- Vancouver Coastal Health Research Institute, Vancouver, BC, Canada.,School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada
| | - Krisztina Vasarhelyi
- Vancouver Coastal Health Research Institute, Vancouver, BC, Canada.,Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
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14
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Wu J, Ma Y, Zuo Y, Zheng K, Zhou Z, Qin Y, Ren Z. Effects of Mindfulness Exercise Guided by a Smartphone App on Negative Emotions and Stress in Non-Clinical Populations: A Systematic Review and Meta-Analysis. Front Public Health 2022; 9:773296. [PMID: 35155341 PMCID: PMC8825782 DOI: 10.3389/fpubh.2021.773296] [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: 09/09/2021] [Accepted: 12/24/2021] [Indexed: 11/23/2022] Open
Abstract
Background Studies have acknowledged that mindfulness exercise guided by a smartphone app has a positive impact on mental health and physical health. However, mindfulness guided by a smartphone app on mental health is still in its infancy stage. Therefore, we conducted a meta-analysis evaluating the effect of mindfulness intervention guided by a smartphone app on negative emotions and stress in a non-clinical population with emotional symptoms. Methods We searched major databases, namely, Web of Science, PubMed, Scopus, China National Knowledge Infrastructure (CNKI), and Wanfang, to identify all of the relevant studies published in English or Chinese from their inception until November 9, 2021. The methodological quality of the included studies was assessed with Cochrane risk-of-bias bias assessment tool. Two researchers independently conducted document retrieval, study selection, data extraction, and methodological quality evaluation. Result A total of eight studies were included in the study, with 574 subjects (experimental group: 348; control group: 226). A random effects model was selected to combine effect sizes. The results of the meta-analysis showed that mindfulness exercise guided by a smartphone app reduced negative emotions [standardized mean difference (SMD) = −0.232, 95% CI: −0.398 to −0.066, p = 0.006], depressive symptoms (SMD = −0.367, 95% CI: −0.596 to −0.137, p = 0.002), and anxiety symptoms (SMD = −0.490, 95% CI: −0.908 to −0.071, p = 0.022). Conclusions The findings indicate the potentially beneficial effect of mindfulness exercise guided by a smartphone app on symptoms of depression and anxiety among individuals in a non-clinical population with emotional symptoms. Considering the small number and overall methodological weakness of the included studies and lack of randomized controlled trials (RCTs), the results should be interpreted with caution, and future rigorously designed RCTs are warranted to provide more reliable evidence.
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Affiliation(s)
- Jinlong Wu
- Department of Physical Education, Shenzhen University, Shenzhen, China.,Institute of Textiles and Clothing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Yudan Ma
- College of Teaching Common Courses, Shanwei Polytechnic, Shanwei, China
| | - Yifan Zuo
- Department of Physical Education, Shenzhen University, Shenzhen, China
| | - Kangyong Zheng
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | | | - Yifan Qin
- Department of Physical Education, Shenzhen University, Shenzhen, China
| | - Zhanbing Ren
- Department of Physical Education, Shenzhen University, Shenzhen, China
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15
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Shah A, Hussain-Shamsy N, Strudwick G, Sockalingam S, Nolan RP, Seto E. Digital Health Interventions for Depression and Anxiety Among People with Chronic Conditions: Scoping Review (Preprint). J Med Internet Res 2022; 24:e38030. [PMID: 36155409 PMCID: PMC9555324 DOI: 10.2196/38030] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 07/12/2022] [Accepted: 08/11/2022] [Indexed: 12/03/2022] Open
Abstract
Background Chronic conditions are characterized by their long duration (≥1 year), need for ongoing medical attention, and limitations in activities of daily living. These can often co-occur with depression and anxiety as common and detrimental comorbidities among the growing population living with chronic conditions. Digital health interventions (DHIs) hold promise in overcoming barriers to accessing mental health support for these individuals; however, the design and implementation of DHIs for depression and anxiety in people with chronic conditions are yet to be explored. Objective This study aimed to explore what is known in the literature regarding DHIs for the prevention, detection, or treatment of depression and anxiety among people with chronic conditions. Methods A scoping review of the literature was conducted using the Arksey and O’Malley framework. Searches of the literature published in 5 databases between 1990 and 2019 were conducted in April 2019 and updated in March 2021. To be included, studies must have described a DHI tested with, or designed for, the prevention, detection, or treatment of depression or anxiety in people with common chronic conditions (arthritis, asthma, diabetes mellitus, heart disease, chronic obstructive pulmonary disease, cancer, stroke, and Alzheimer disease or dementia). Studies were independently screened by 2 reviewers against the inclusion and exclusion criteria. Both quantitative and qualitative data were extracted, charted, and synthesized to provide a descriptive summary of the trends and considerations for future research. Results Database searches yielded 11,422 articles across the initial and updated searches, 53 (0.46%) of which were included in this review. DHIs predominantly sought to provide treatment (44/53, 83%), followed by detection (5/53, 9%) and prevention (4/53, 8%). Most DHIs were focused on depression (36/53, 68%), guided (32/53, 60%), tailored to chronic physical conditions (19/53, 36%), and delivered through web-based platforms (20/53, 38%). Only 2 studies described the implementation of a DHI. Conclusions As a growing research area, DHIs offer the potential to address the gap in care for depression and anxiety among people with chronic conditions; however, their implementation in standard care is scarce. Although stepped care has been identified as a promising model to implement efficacious DHIs, few studies have investigated the use of DHIs for depression and anxiety among chronic conditions using such models. In developing stepped care, we outlined DHI tailoring, guidance, and intensity as key considerations that require further research.
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Affiliation(s)
- Amika Shah
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Centre for Global eHealth Innovation, University Health Network, Toronto, ON, Canada
| | - Neesha Hussain-Shamsy
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Centre for Global eHealth Innovation, University Health Network, Toronto, ON, Canada
| | - Gillian Strudwick
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Sanjeev Sockalingam
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- University Health Network, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Robert P Nolan
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Cardiac eHealth, Toronto General Hospital, University Health Network, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Emily Seto
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Centre for Global eHealth Innovation, University Health Network, Toronto, ON, Canada
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16
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Sánchez‐Gutiérrez C, Gil‐García E, Rivera‐Sequeiros A, López‐Millán JM. Effectiveness of telemedicine psychoeducational interventions for adults with non‐oncological chronic disease: A systematic review. J Adv Nurs 2022; 78:1267-1280. [DOI: 10.1111/jan.15151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 11/16/2021] [Accepted: 12/12/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Carmen Sánchez‐Gutiérrez
- Department of Anesthesiology and Pain Medicine Virgen del Rocío Universitary Hospital Seville Spain
| | - Eugenia Gil‐García
- Department of Nursing, Faculty of Nursing, Physiotherapy and Podiatry University of Seville Seville Spain
| | - Adriana Rivera‐Sequeiros
- Department of Nursing Research and Innovation in Digital Health Virgen Macarena Universitary Hospital Seville Spain
| | - José M. López‐Millán
- Department of Anesthesiology and Pain Medicine Virgen Macarena Universitary Hospital Seville Spain
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17
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Pach D, Blödt S, Wang J, Keller T, Bergmann B, Rogge AA, Barth J, Icke K, Roll S, Witt CM. App-Based Relaxation Exercises for Patients With Chronic Neck Pain: Pragmatic Randomized Trial. JMIR Mhealth Uhealth 2022; 10:e31482. [PMID: 34994708 PMCID: PMC8783271 DOI: 10.2196/31482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 09/11/2021] [Accepted: 11/12/2021] [Indexed: 12/05/2022] Open
Abstract
Background Chronic neck pain is a highly prevalent condition. Learning a relaxation technique is recommended by numerous guidelines for chronic neck pain. Smartphone apps can provide relaxation exercises; however, their effectiveness, especially in a self-care setting, is unclear. Objective The aim of this pragmatic randomized trial is to evaluate whether app-based relaxation exercises, including audio-based autogenic training, mindfulness meditation, or guided imagery, are more effective in reducing chronic neck pain than usual care alone. Methods Smartphone owners aged 18 to 65 years with chronic (>12 weeks) neck pain and the previous week’s average neck pain intensity ≥4 on the Numeric Rating Scale (0=no pain to 10=worst possible pain) were randomized into either an intervention group to practice app-based relaxation exercises or a control group (usual care and app for data entry only). For both groups, the follow-up data were collected using app-based diaries and questionnaires. The primary outcome was the mean neck pain intensity during the first 3 months based on daily measurements. Secondary outcomes included neck pain based on weekly measurements, pain acceptance, neck pain–related stress, sick-leave days, pain medication intake, and adherence, which were all measured until the 6-month follow-up. For the primary analysis, analysis of covariance adjusted for baseline neck pain intensity was used. Results We screened 748 participants and enrolled 220 participants (mean age 38.9, SD 11.3 years; mean baseline neck pain 5.7, SD 1.3 points). The mean neck pain intensity in both groups decreased over 3 months; however, no statistically significant difference between the groups was found (intervention: 4.1 points, 95% CI 3.8-4.4; control: 3.8 points, 95% CI 3.5-4.1; group difference: 0.3 points, 95% CI −0.2 to 0.7; P=.23). In addition, no statistically significant between-group differences regarding neck pain intensity after 6 months, responder rate, pain acceptance, pain medication intake, or sick-leave days were observed. There were no serious adverse events that were considered related to the trial intervention. In week 12, only 40% (44/110) of the participants in the intervention group continued to practice the exercises with the app. Conclusions The study app did not effectively reduce chronic neck pain or keep the participants engaged in exercising in a self-care setting. Future studies on app-based relaxation interventions should take into account the most recent scientific findings for behavior change techniques. Trial Registration ClinicalTrials.gov NCT02019134; https://clinicaltrials.gov/ct2/show/NCT02019134 International Registered Report Identifier (IRRID) RR2-10.1186/1745-6215-15-490
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Affiliation(s)
- Daniel Pach
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Susanne Blödt
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Jiani Wang
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Theresa Keller
- Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Berlin, Germany
| | - Beatrice Bergmann
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Alizé A Rogge
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Jürgen Barth
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Katja Icke
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Stephanie Roll
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Claudia M Witt
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
- Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
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18
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Ciucă A, Moldovan R, Băban A. Mapping psychosocial interventions in familial colorectal cancer: a rapid systematic review. BMC Cancer 2022; 22:8. [PMID: 34980016 PMCID: PMC8722202 DOI: 10.1186/s12885-021-09086-8] [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: 02/09/2021] [Accepted: 10/12/2021] [Indexed: 11/29/2022] Open
Abstract
Background Approximately 5% of colorectal cancer (CRC) cases are part of a well-defined inherited genetic syndrome and up to approximately 30% of these cases have a clinically defined familial basis. Psychosocial interventions in familial colorectal cancer address aspects mainly focused on affective, cognitive and behavioural outcomes. The present review aims to systematically map out the available psychosocial interventions for individuals with a family history of CRC and describe the current state of the research. Methods An extensive electronic search was conducted to investigate the literature published until June 2020. Inclusion criteria consisted of quantitative studies published in English that explored the impact of psychosocial interventions for familial CRC, clearly defined the psychosocial intervention offered and included participants with a family history of CRC. Results The analysis included 52 articles. Genetic counselling, educational interventions, psychological interventions and multimodal interventions were identified across the studies. In terms of diagnoses, Lynch Syndrome, Familial Adenomatous Polyposis, Familial Colorectal Cancer were the main conditions included in the studies. Affective, cognitive, behavioural aspects and quality of life emerged as the most frequently explored outcomes. The studies included individuals with both personal and familial history of CRC or family history alone. Conclusions Our rapid review provides an overview of the literature exploring the impact of psychosocial interventions for familial CRC. The psychosocial interventions identified had an overwhelmingly positive impact across all types of outcomes measured. Genetic counselling appeared to be most beneficial, and this is expected as it is purposively designed to address genetic conditions. Further quantitative analysis of primary empirical research is needed to determine the efficacy and effectiveness of psychosocial interventions as well as the mechanisms through which they exert their effect.
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Affiliation(s)
- Andrada Ciucă
- Department of Psychology, Babeş-Bolyai University, Cluj-Napoca, Romania
| | - Ramona Moldovan
- Department of Psychology, Babeş-Bolyai University, Cluj-Napoca, Romania. .,Division of Evolution and Genomic Sciences, School of Biological Science, University of Manchester, Manchester, UK. .,Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester, UK.
| | - Adriana Băban
- Department of Psychology, Babeş-Bolyai University, Cluj-Napoca, Romania
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19
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Minen MT, Busis NA, Friedman S, Campbell M, Sahu A, Maisha K, Hossain Q, Soviero M, Verma D, Yao L, Foo FYA, Bhatt JM, Balcer LJ, Galetta SL, Thawani S. The use of virtual complementary and integrative therapies by neurology outpatients: An exploratory analysis of two cross-sectional studies assessing the use of technology as treatment in an academic neurology department in New York City. Digit Health 2022; 8:20552076221109545. [PMID: 35874862 PMCID: PMC9297463 DOI: 10.1177/20552076221109545] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 06/08/2022] [Indexed: 11/17/2022] Open
Abstract
Background Prior to the COVID-19 pandemic, about half of patients from populations that sought care in neurology tried complementary and integrative therapies (CITs). With the increased utilization of telehealth services, we sought to determine whether patients also increased their use of virtual CITs. Methods We examined datasets from two separate cross-sectional surveys that included cohorts of patients with neurological disorders. One was a dataset from a study that examined patient and provider experiences with teleneurology visits; the other was a study that assessed patients with a history of COVID-19 infection who presented for neurologic evaluation. We assessed and reported the use of virtual (and non-virtual) CITs using descriptive statistics, and determined whether there were clinical characteristics that predicted the use of CITs using logistic regression analyses. Findings Patients who postponed medical treatment for non-COVID-19-related problems during the pandemic were more likely to seek CITs. Virtual exercise, virtual psychotherapy, and relaxation/meditation smartphone applications were the most frequent types of virtual CITs chosen by patients. In both studies, age was a key demographic factor associated with mobile/virtual CIT usage. Interpretations Our investigation demonstrates that virtual CIT-related technologies were utilized in the treatment of neurologic conditions during the pandemic, particularly by those patients who deferred non-COVID-related care.
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Affiliation(s)
- Mia T Minen
- Department of Neurology, NYU Langone Health, New York, NY, USA
- Department of Population Health, NYU Langone Health, New York, NY, USA
| | - Neil A Busis
- Department of Neurology, NYU Langone Health, New York, NY, USA
| | - Steven Friedman
- Department of Population Health, NYU Langone Health, New York, NY, USA
| | - Maya Campbell
- Barnard College, Columbia University, New York, NY, USA
| | - Ananya Sahu
- The City College of New York, New York, NY, USA
| | - Kazi Maisha
- Department of Ophthalmology, NYU Langone Health, New York, NY, USA
| | - Quazi Hossain
- Department of Ophthalmology, NYU Langone Health, New York, NY, USA
| | - Mia Soviero
- The City College of New York, New York, NY, USA
| | | | - Leslie Yao
- Barnard College, Columbia University, New York, NY, USA
| | | | - Jaydeep M Bhatt
- Department of Neurology, NYU Langone Health, New York, NY, USA
| | - Laura J Balcer
- Department of Neurology, NYU Langone Health, New York, NY, USA
- Department of Population Health, NYU Langone Health, New York, NY, USA
- Department of Ophthalmology, NYU Langone Health, New York, NY, USA
| | - Steven L Galetta
- Department of Neurology, NYU Langone Health, New York, NY, USA
- Department of Ophthalmology, NYU Langone Health, New York, NY, USA
| | - Sujata Thawani
- Department of Neurology, NYU Langone Health, New York, NY, USA
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20
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Li J, Zhu C, Liu C, Su Y, Peng X, Hu X. Effectiveness of eHealth interventions for cancer-related pain, fatigue, and sleep disorders in cancer survivors: A systematic review and meta-analysis of randomized controlled trials. J Nurs Scholarsh 2021; 54:184-190. [PMID: 34791779 DOI: 10.1111/jnu.12729] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 09/13/2021] [Accepted: 10/15/2021] [Indexed: 02/05/2023]
Abstract
PURPOSE To systematically evaluate the effects of Electronic health (eHealth) interventions on fatigue, pain, and sleep disorders in cancer survivors. DESIGN A systematic review and meta-analysis was conducted. METHODS Relevant studies were searched from five databases (MEDLINE, Embase, the Cochrane Central Register of Controlled trials, CINAHL, and PsycINFO). The comprehensive literature search was done in December 2020. Only randomized controlled trials (RCTs) that examined the effects of eHealth interventions among cancer survivors were included. FINDINGS Twenty-five RCTs were included. The meta-analysis showed that eHealth interventions had a positive impact on pain interference (SMD = -0.37, 95% CI: -0.54 to -0.20, p = 0.0001) and sleep disorders (SMD = -0.43, 95% CI: -0.77 to -0.08, p = 0.02) but not on pain severity or fatigue in cancer survivors. The sensitivity and subgroup analyses indicated that the pooled results were robust and reliable. CONCLUSION eHealth interventions are effective in improving pain interference and sleep disorders in cancer survivors. Additional high-quality RCTs are needed to test the effectiveness of eHealth interventions on fatigue, pain, and sleep disorders in cancer survivors. CLINICAL RELEVANCE This systematic review and meta-analysis provides evidence to offer effective and sustainable eHealth care for symptom management among cancer survivors.
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Affiliation(s)
- Juejin Li
- West China School of Nursing, Sichuan University/Department of Nursing, West China Hospital, Sichuan University, Chengdu, PR China
| | - Chuanmei Zhu
- Outpatient Department, West China Hospital, Sichuan University, Chengdu, PR China
| | - Chunhua Liu
- Department of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, PR China
| | - Yonglin Su
- Department of Rehabilitation/Department of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, PR China
| | - Xingchen Peng
- Department of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, PR China
| | - Xiaolin Hu
- West China School of Nursing, Sichuan University/Department of Nursing, West China Hospital, Sichuan University, Chengdu, PR China
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21
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Dragomanovich HM, Dhruva A, Ekman E, Schoenbeck KL, Kubo A, Van Blarigan EL, Borno HT, Esquivel M, Chee B, Campanella M, Philip EJ, Rettger JP, Rosenthal B, Van Loon K, Venook AP, Boscardin C, Moran P, Hecht FM, Atreya CE. Being Present 2.0: Online Mindfulness-Based Program for Metastatic Gastrointestinal Cancer Patients and Caregivers. Glob Adv Health Med 2021; 10:21649561211044693. [PMID: 35174001 PMCID: PMC8842457 DOI: 10.1177/21649561211044693] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
PURPOSE A metastatic cancer diagnosis is associated with high levels of distress in patients and caregivers, which may be alleviated by mindfulness interventions. Research on scalable, tailored, online mindfulness training programs is needed. We sought to test the feasibility and acceptability of a remotely delivered 8-week mindfulness-based intervention, Being Present 2.0 (BP2.0). METHODS We performed a single-arm feasibility study of BP2.0 among patients with any metastatic gastrointestinal cancer receiving chemotherapy, with or without an informal caregiver. Participants were instructed to practice mindfulness using pre-recorded guided meditations 5 times per week using a study-specific website and to attend a weekly live, interactive virtual meeting facilitated by a trained instructor. The web-based platform enabled direct measurement of adherence. RESULTS The study enrolled 46 of 74 (62%) patients contacted, together with 23 caregivers (69 participants total), from May to October 2018. Median patient age was 52 (range 20-70 years), 39% were male, 67% non-Hispanic white, 65% had colorectal cancer, and 78% lived outside of San Francisco. The top reasons cited for participation were to reduce stress/anxiety and learn how to meditate. Mean baseline National Comprehensive Cancer Network Distress Thermometer (NCCN DT) scores were 4.7 (patients) and 5.8 (caregivers). The study discontinuation rate was 20% (eight patients and six caregivers). Among the remaining 55 participants, 43 (78%) listened to at least one audio recording and/or attended at least one virtual meeting, although adherence data was incomplete. The retention rate was 71%, with 39 participants completing at least one follow-up assessment. In post-intervention qualitative interviews, 88% of respondents reported a positive experience. Compared to baseline, participants reported significantly reduced post-intervention NCCN DT scores (mean 3.1; P = .012). CONCLUSION The BP2.0 online mindfulness-based program is feasible and acceptable for patients with metastatic gastrointestinal cancer and caregivers. These results will guide plans for a follow-up efficacy study. ClinicalTrials.gov Identifier: NCT03528863.
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Affiliation(s)
- Hannah M. Dragomanovich
- University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
- College of Osteopathic Medicine, Touro University California, Vallejo, CA, USA
| | - Anand Dhruva
- University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
- UCSF Osher Center for Integrative Medicine, CA, USA
- UCSF Department of Medicine, CA, USA
| | - Eve Ekman
- UCSF Osher Center for Integrative Medicine, CA, USA
- Greater Good Science Center, University of California Berkeley, Berkeley, CA, USA
| | - Kelly L. Schoenbeck
- University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
- UCSF Department of Medicine, CA, USA
| | - Ai Kubo
- Kaiser Permanente Division of Research, CA, USA
| | | | - Hala T. Borno
- University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
- UCSF Department of Medicine, CA, USA
| | - Mikaela Esquivel
- University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| | - Bryant Chee
- University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
- College of Osteopathic Medicine, Touro University California, Vallejo, CA, USA
| | - Matthew Campanella
- University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| | | | - John P. Rettger
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Blake Rosenthal
- University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
- UCSF Benioff Children’s Hospital Oakland, CA, USA
| | - Katherine Van Loon
- University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
- UCSF Department of Medicine, CA, USA
| | - Alan P. Venook
- University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
- UCSF Department of Medicine, CA, USA
| | | | - Patricia Moran
- University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
- UCSF Osher Center for Integrative Medicine, CA, USA
| | - Frederick M. Hecht
- UCSF Osher Center for Integrative Medicine, CA, USA
- UCSF Department of Medicine, CA, USA
| | - Chloe E. Atreya
- University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
- UCSF Osher Center for Integrative Medicine, CA, USA
- UCSF Department of Medicine, CA, USA
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22
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Hesse C, Shorey RC, Brem MJ, Stuart GL, Cornelius TL. A Short-Term Longitudinal Investigation of the Relationship Between Trait Mindfulness and Female-Perpetrated Dating Violence. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP10958-NP10978. [PMID: 31583966 DOI: 10.1177/0886260519879264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Within the past several decades, dating violence has emerged as a major health problem, with rates of physical violence ranging from 20% to 30% and psychological aggression ranging from 60% to 90% in college dating relationships. Despite this, there have been few successful dating violence prevention programs developed. Thus, it is imperative that research can identify the relationship between potential protective factors, such as trait mindfulness, and dating violence perpetration. This study builds upon previous research on mindfulness and dating violence by investigating this question within a sample of female undergraduate students at two universities (N = 381) over the course of one semester. Findings suggested that the nonjudging aspect of mindfulness was associated with less perpetration of psychological and physical aggression approximately 3 months later. Furthermore, several facets of mindfulness were able to differentiate individuals who perpetrated aggression at Time 2 relative to individuals without a history of perpetration. These findings build on previous work in the field and suggest that mindfulness may play an important role in the manifestation of dating violence. Directions for future research on the relation between mindfulness and dating violence are discussed.
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Affiliation(s)
- Calvin Hesse
- Grand Valley State University, Allendale, MI, USA
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23
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Kömürkara S, Cengiz Z. Effects of Progressive Relaxation Exercises on Vital Signs and Fatigue in Liver Transplant Patients: A Randomized Controlled Trial. Clin Nurs Res 2021; 31:497-508. [PMID: 34528495 DOI: 10.1177/10547738211045850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This randomized controlled study was conducted to evaluate the effects of progressive relaxation exercises on vital signs and fatigue level. Ninety patients with liver transplantation (experimental group = 45, control group = 45) were included in the study. The patients in the experimental group performed progressive relaxation exercises for 25 to 30 minutes every day for 4 weeks. Before the progressive relaxation exercises, the vital signs and fatigue level of the patients were recorded. Vital signs were recorded again immediately after the progressive relaxation exercises and at the end of the second week. At the end of the fourth week, the final measurement of vital signs was performed along with the second fatigue level assessment. In the experimental group, pulse and respiratory rates, systolic and diastolic blood pressure values, and fatigue severity mean scores were found to be lower and oxygen saturation level was higher than those of the control group. The improvement in vital signs in the experimental group was evident at week 3 (p < .05).
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Affiliation(s)
| | - Zeliha Cengiz
- Inonu University, Nursing Faculty, Department of Fundamentals of Nursing, Malatya, Turkey
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24
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Kogan LR, Bussolari C. Exploring the Potential Impact of a Virtual Body Scan Meditation Exercise Conducted With Pet Dogs on Recipients and Facilitators. Front Psychol 2021; 12:698075. [PMID: 34335415 PMCID: PMC8322236 DOI: 10.3389/fpsyg.2021.698075] [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: 04/20/2021] [Accepted: 06/21/2021] [Indexed: 11/14/2022] Open
Abstract
Numerous recent studies have shown that COVID-19 and the accompanying mandated lifestyle changes have resulted in significant negative effects on people's mental health. To meet the increased need for mental health support, while also maintaining physical safety, a variety of telehealth services have been created or expanded. A body scan mindfulness program is an intervention that can easily be modified to be offered virtually. This study was designed to determine if a virtual body scan mindfulness exercise, with participants' holding their dog or a pillow/blanket, could reduce their stress and anxiety as well as that of the facilitators. Significant differences in pre/post-State Anxiety Assessment scores for participants and facilitators were found. These results are discussed within the framework of the human animal bond and the potential of this form of intervention as a useful virtual tool for participants and facilitators alike.
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Affiliation(s)
- Lori R. Kogan
- Department of Clincal Sciences, Colorado State University, Fort Collins, CO, United States
| | - Cori Bussolari
- Department of Clinical Psychology, University of San Francisco, San Francisco, CA, United States
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25
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Kim J, Gray JA, Johnson H. The Effect of a Web-Based Deep Breathing App on Stress of Direct Care Workers: Uncontrolled Intervention Study. J Altern Complement Med 2021; 27:876-883. [PMID: 34227854 DOI: 10.1089/acm.2020.0541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objectives: Studies have demonstrated success in reducing stress levels in complex interventions including deep breathing components. Breathing exercise interventions, however, tend not to be studied in isolation. The aim of the study was to examine the impact of a breathing exercise using a web-based app on the stress levels of direct care workers (DCWs) who serve people with intellectual and developmental disabilities. Design: Uncontrolled one-group intervention. Settings/Location: DCWs were recruited from intellectual and developmental disability service providers in a US Midwestern state. Subjects: Sixty-four DCWs who used the breathing exercise app at least 2 times. Interventions: Breathing exercise using a web-based app for a month. Outcome measures: Five measures were obtained from the data recorded in the app: initial stress level before exercise, exercise duration in minutes, change in stress level between before and after each breathing exercise, and frequency and number of days the app was used during a month. Participants' self-report of the number of days of app use was collected in a 1-month follow-up survey. Results: The participants appear to have a moderate stress level indicated by the initial stress level 5 out of 10. After the breathing exercise, the stress level decreased by 1.2 points from 5.0 (standard deviation [SD] = 1.8) to 3.7 (SD = 1.6) on average (paired t-test, p < 0.00005). Cohen's d 0.72 indicates a large effect size. Among within-individual factors, a higher initial stress level and longer app use per occasion were significantly associated with stress reduction. Among between-individual factors, only race was associated with stress reduction. Although there was no effect of being an African American alone on stress level change (coefficient = 0.44, 95% confidence interval = -0.29 to 1.18, p > 0.05), there was an additional reduction among African Americans in relation to the initial stress level, controlling for exercise duration. The number of breathing exercise days recorded in the app was not correlated with that of self-report (Pearson's correlation r = 0.12, p > 0.05). Although the app was used for 4.4 (SD = 4.2) days, participants reported using it for 10.7 (SD = 8.2) days on average in the follow-up survey. Conclusions: The findings suggest the benefit of breathing exercises using an app for reducing DCWs' stress levels. Regular use of such apps may assist with stress management and bolster overall health and well-being among DCWs.
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Affiliation(s)
- Jinsook Kim
- School of Health Studies, Northern Illinois University, DeKalb, IL, USA
| | - Jennifer A Gray
- School of Health Studies, Northern Illinois University, DeKalb, IL, USA
| | - Hannah Johnson
- School of Health Professions, Concordia University Wisconsin, Mequon, WI, USA
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26
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Fritz JM, Davis AF, Burgess DJ, Coleman B, Cook C, Farrokhi S, Goertz C, Heapy A, Lisi AJ, McGeary DD, Rhon DI, Taylor SL, Zeliadt S, Kerns RD. Pivoting to virtual delivery for managing chronic pain with nonpharmacological treatments: implications for pragmatic research. Pain 2021; 162:1591-1596. [PMID: 33156148 PMCID: PMC8089114 DOI: 10.1097/j.pain.0000000000002139] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 10/28/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Julie M Fritz
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, United States
| | - Alison F Davis
- Pain Management Collaboratory, Department of Psychiatry (dept. affiliation for Dr. Davis) Yale University School of Medicine, New Haven, CT, United States
| | - Diana J Burgess
- VA HSR&D Center for Care Delivery and Outcomes Research, Minneapolis VA Medical Center, Minneapolis, MN, United States. Dr. Burgess is now with Department of Medicine (dept. affiliation for Dr. Burgess) University of Minnesota Medical School, Minneapolis, MN, United States
| | - Brian Coleman
- Pain Research, Informatics, Multimorbidities, and Education (PRIME) Center, VA Connecticut Healthcare System, Pain Management Collaboratory Coordinating Center, Yale School of Medicine, New Haven, CT, United States
| | - Chad Cook
- Doctor of Physical Therapy Division, Duke University School of Medicine, Durham, NC, United States
| | - Shawn Farrokhi
- DoD-VA Extremity and Amputation Center of Excellence, Department of Physical and Occupational Therapy, Naval Medical Center, San Diego, CA, United States
| | - Christine Goertz
- Department of Orthopaedics, Duke University School of Medicine, and Core Faculty Member, Duke-Margolis Center for Health Policy, Durham, NC, United States
| | - Alicia Heapy
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States. Dr. Heapy is now with VA Connecticut Healthcare System Pain Research, Informatics, Multimorbidities, and Education (PRIME) Center, Health Services Research and Development Center of Innovation, West Haven/Yale School of Medicine, New Haven, CT, United States
| | - Anthony J Lisi
- Department of Veterans Affairs, and Associate Research Scientist, Yale Center for Medical Informatics, Yale University School of Medicine, New Haven, CT, United States
| | - Donald D McGeary
- Departments of Rehabilitation Medicine and Psychiatry (Dept. affiliation for Dr. McGeary) University of Texas Health, San Antonio, TX, United States
| | - Daniel I Rhon
- Brooke Army Medical Center and Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Stephanie L Taylor
- VA HSR&D, VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States. Dr. McGeary is now with Departments of Medicine and Health Policy and Management, UCLA, Los Angeles, CA, United States
| | - Steven Zeliadt
- Veterans Administration Puget Sound Health Care System, Department of Health Services, University of Washington, Seattle, WA, United States
| | - Robert D Kerns
- Departments of Psychiatry, Neurology, and Psychology, Yale University, New Haven, CT, United States. Dr. Kerns is now with VA Connecticut Healthcare System Pain Research, Informatics, Multimorbidities, and Education (PRIME) Center, West Haven, CT, United States
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27
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Mindfulness for patients undergoing surgery: a cost-effective and potentially underrated tool for improving outcomes. Br J Anaesth 2021; 127:e22-e24. [PMID: 34024639 PMCID: PMC9246505 DOI: 10.1016/j.bja.2021.03.038] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 03/10/2021] [Accepted: 03/29/2021] [Indexed: 11/28/2022] Open
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28
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Siebenhüner AR, Mikolasek M, Witt CM, Barth J. Improvements in Health Might Contradict Adherence to Mobile Health Interventions: Findings from a Self-Care Cancer App Study. J Altern Complement Med 2021; 27:S115-S123. [PMID: 33788602 DOI: 10.1089/acm.2020.0111] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background: Cancer patients often suffer from high levels of distress. Mobile health (mHealth) applications might be an innovative way to deliver mindfulness and relaxation interventions for cancer patients. However, data about the implementation of apps in health care are lacking. Adherence to mHealth interventions is an important indicator for a successful implementation and might be needed to maximize treatment effects. However, the decrease in distress might reduce the motivation of patients to engage in such self-care tools in the long run. Therefore, the aim of this analysis was to investigate the association between the course of distress over time and the adherence to a relaxation self-care app in cancer patients. Methods: We developed an app for cancer patients (CanRelax) and 83 patients who participated in the prospective observational study used the app at least once. The evaluation was guided by the RE-AIM framework, and this analysis focused on the implementation of the app. Patients were grouped into five subgroups according to their course of distress over 10 weeks (Distress Thermometer). These subgroups of patients were compared with each other to identify different user groups. Findings: About half of the patients were adherent over 10 weeks. However, a decrease in distress was associated with lower adherence to the app intervention, whereas patients with moderate distress or an increase in distress showed more adherence. Conclusion: Adherence to an app intervention might be also driven by patients' distress level. A decrease in distress might reduce patients' motivation to continue with a self-care intervention. The interplay between adherence and treatment outcomes should be explored in upcoming mHealth trials to get a better understanding for the implementation of such interventions. Encouraging patients to continue self-care interventions is a major challenge in integrative medicine if they are delivered digitally. The Clinical Trial Registration number: DRKS00010481.
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Affiliation(s)
- Alexander R Siebenhüner
- Clinic for Medical Oncology and Hematology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Michael Mikolasek
- Institute for Complementary and Integrative Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Claudia M Witt
- Institute for Complementary and Integrative Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.,Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Jürgen Barth
- Institute for Complementary and Integrative Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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29
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Ben-Arye E, Paller CJ, Lopez AM, White S, Pendleton E, Kienle GS, Samuels N, Abbawaajii N, Balneaves LG. The Society for Integrative Oncology Practice Recommendations for online consultation and treatment during the COVID-19 pandemic. Support Care Cancer 2021; 29:6155-6165. [PMID: 33852088 PMCID: PMC8044504 DOI: 10.1007/s00520-021-06205-w] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 04/05/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The Society for Integrative Oncology (SIO) Online Task Force was created in response to the challenges facing continuity of integrative oncology care resulting from the COVID-19 pandemic. The Task Force set out to guide integrative oncology practitioners in providing effective and safe online consultations and treatments for quality-of-life-concerns and symptom management. Online treatments include manual, acupuncture, movement, mind-body, herbal, and expressive art therapies. METHODS The SIO Online Practice Recommendations employed a four-phase consensus process: (1) literature review and discussion among an international panel of SIO members, identifying key elements essential in an integrative oncology visit; (2) development, testing, and refinement of a questionnaire defining challenges and strategies; (3) refinement input from integrative oncology experts from 19 countries; and (4) SIO Executive Committee review identifying the most high-priority challenges and strategies. RESULTS The SIO Online Practice Recommendations address ten challenges, providing practical suggestions for online treatment/consultation. These include overcoming unfamiliarity, addressing resistance among patients and healthcare practitioners to online consultation/treatment, exploring ethical and medical-legal aspects, solving technological issues, preparing the online treatment setting, starting the online treatment session, maintaining effective communication, promoting specific treatment effects, involving the caregiver, concluding the session, and ensuring continuity of care. CONCLUSIONS The SIO Online Practice Recommendations are relevant for ensuring continuity of care beyond the present pandemic. They can be implemented for patients with limited accessibility to integrative oncology treatments due to geographic constraints, financial difficulties, physical disability, or an unsupportive caregiver. These recommendations require further study in practice settings.
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Affiliation(s)
- Eran Ben-Arye
- Integrative Oncology Program, Lin, Zebulon, & Carmel Medical Centers, Clalit Health Services; Faculty of Medicine, Technion - Israel Institute of Technology, 35 Rothschild St, Haifa, Israel.
| | | | - Ana Maria Lopez
- Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA
| | - Shelley White
- Wellness and Integrative Health Center, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Eva Pendleton
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Gunver S Kienle
- Center for Complementary Medicine, Institute for Infection Prevention and Hospital Epidemiology, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany.,Institute for Applied Epistemology and Medical Methodology, University of Witten/Herdecke, Freiburg, Germany
| | - Noah Samuels
- Center for Integrative Complementary Medicine, Shaarei Zedek Medical Center, Israel; Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Nuria Abbawaajii
- College of Nursing, University of Manitoba, Winnipeg, MB, Canada
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30
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Sasseville M, LeBlanc A, Boucher M, Dugas M, Mbemba G, Tchuente J, Chouinard MC, Beaulieu M, Beaudet N, Skidmore B, Cholette P, Aspiros C, Larouche A, Chabot G, Gagnon MP. Digital health interventions for the management of mental health in people with chronic diseases: a rapid review. BMJ Open 2021; 11:e044437. [PMID: 33820786 PMCID: PMC8030477 DOI: 10.1136/bmjopen-2020-044437] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE Determine the effectiveness of digital mental health interventions for individuals with a concomitant chronic disease. DESIGN We conducted a rapid review of systematic reviews. Two reviewers independently conducted study selection and risk of bias evaluation. A standardised extraction form was used. Data are reported narratively. INTERVENTIONS We included systematic reviews of digital health interventions aiming to prevent, detect or manage mental health problems in individuals with a pre-existing chronic disease, including chronic mental health illnesses, published in 2010 or after. MAIN OUTCOME MEASURE Reports on mental health outcomes (eg, anxiety symptoms and depression symptoms). RESULTS We included 35 reviews, totalling 702 primary studies with a total sample of 50 692 participants. We structured the results in four population clusters: (1) chronic diseases, (2) cancer, (3) mental health and (4) children and youth. For populations presenting a chronic disease or cancer, health provider directed digital interventions (eg, web-based consultation, internet cognitive-behavioural therapy) are effective and safe. Further analyses are required in order to provide stronger recommendations regarding relevance for specific population (such as children and youth). Web-based interventions and email were the modes of administration that had the most reports of improvement. Virtual reality, smartphone applications and patient portal had limited reports of improvement. CONCLUSIONS Digital technologies could be used to prevent and manage mental health problems in people living with chronic conditions, with consideration for the age group and type of technology used.
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Affiliation(s)
- Maxime Sasseville
- Department of Health Sciences, Université du Québec à Chicoutimi, Chicoutimi, Québec, Canada
- Nursing Faculty, Université Laval, Quebec, Québec, Canada
- VITAM Research Center on Sustainable Health, Québec, Québec, Canada
| | - Annie LeBlanc
- VITAM Research Center on Sustainable Health, Québec, Québec, Canada
- Family medicine and emergency medicine, Université Laval, Quebec, Québec, Canada
| | - Mylène Boucher
- VITAM Research Center on Sustainable Health, Québec, Québec, Canada
| | - Michèle Dugas
- VITAM Research Center on Sustainable Health, Québec, Québec, Canada
| | - Gisele Mbemba
- VITAM Research Center on Sustainable Health, Québec, Québec, Canada
| | - Jack Tchuente
- VITAM Research Center on Sustainable Health, Québec, Québec, Canada
| | | | - Marianne Beaulieu
- Nursing Faculty, Université Laval, Quebec, Québec, Canada
- VITAM Research Center on Sustainable Health, Québec, Québec, Canada
| | - Nicolas Beaudet
- Omnimed, Québec, Québec, Canada
- Department of Anesthesiology, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Becky Skidmore
- Independent information specialist, Ottawa, Ontario, Canada
| | - Pascale Cholette
- Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale du Québec, Quebec, Quebec, Canada
| | | | | | | | - Marie-Pierre Gagnon
- Nursing Faculty, Université Laval, Quebec, Québec, Canada
- VITAM Research Center on Sustainable Health, Québec, Québec, Canada
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31
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Gál É, Ștefan S, Cristea IA. The efficacy of mindfulness meditation apps in enhancing users' well-being and mental health related outcomes: a meta-analysis of randomized controlled trials. J Affect Disord 2021; 279:131-142. [PMID: 33049431 DOI: 10.1016/j.jad.2020.09.134] [Citation(s) in RCA: 74] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 07/30/2020] [Accepted: 09/27/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Mindfulness applications are popular tools for improving well-being, but their effectiveness is unclear. We conducted a meta-analysis of randomized controlled trials (RCTs) that employed a mindfulness meditation app as the main intervention to improve users' well-being and mental-health related outcomes. METHODS A systematic search was conducted in PsycINFO, PubMed, Web of Science, ProQuest Dissertations and Theses Global, the Cochrane Library, Open Grey and ResearchGate through June, 2020. Effects were calculated as standardized mean difference (Hedges' g) between app-delivered mindfulness interventions and control conditions at post-test and pooled with a random-effects model. RESULTS From 2637 records, we selected 34 trials (N = 7566). Significant effect sizes were found at post-test for perceived stress (n = 15; g = 0.46, 95% CI [0.24, .68], I2= 68%), anxiety (n = 15; g = 0.28, 95% CI [0.16, .40], I2= 35%), depression (n = 15; g = 0.33, 95% CI [0.24, .43], I2= 0%), and psychological well-being (n = 5; g = 0.29, 95% CI [0.14, .45], I2= 0%). No significant effects were found for distress at post-test (n = 6; g = 0.10, 95% CI [-0.02, .22], I2= 11%) and general well-being (n = 5; g = 0.14, 95% CI [-0.02, 0.29], I2 = 14%). CONCLUSION AND LIMITATIONS Mindfulness apps seem promising in improving well-being and mental-health, though results should be interpreted carefully due to the small number of included studies, overall uncertain risk of bias and heterogeneity.
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Affiliation(s)
- Éva Gál
- Evidence Based Psychological Assessment and Interventions Doctoral School, Babeș- Bolyai University, Cluj-Napoca, Romania.
| | - Simona Ștefan
- Department of Clinical Psychology and Psychotherapy, Babeș- Bolyai University, Cluj-Napoca, Romania; The International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeș- Bolyai University, Cluj- Napoca, Romania
| | - Ioana A Cristea
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
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32
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Mikolasek M, Witt CM, Barth J. Effects and Implementation of a Mindfulness and Relaxation App for Patients With Cancer: Mixed Methods Feasibility Study. JMIR Cancer 2021; 7:e16785. [PMID: 33439132 PMCID: PMC7840285 DOI: 10.2196/16785] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Revised: 03/13/2020] [Accepted: 11/18/2020] [Indexed: 12/15/2022] Open
Abstract
Background Cancer diagnosis and cancer treatment can cause high levels of distress, which is often not sufficiently addressed in standard medical care. Therefore, a variety of supportive nonpharmacological treatments have been suggested to reduce distress in patients with cancer. However, not all patients use these interventions because of limited access or lack of awareness. To overcome these barriers, mobile health may be a promising way to deliver the respective supportive treatments. Objective The aim of this study is to evaluate the effects and implementation of a mindfulness and relaxation app intervention for patients with cancer as well as patients’ adherence to such an intervention. Methods In this observational feasibility study with a mixed methods approach, patients with cancer were recruited through the web and through hospitals in Switzerland. All enrolled patients received access to a mindfulness and relaxation app. Patients completed self-reported outcomes (general health, health-related quality of life, anxiety, depression, distress, mindfulness, and fear of progression) at baseline and at weeks 4, 10, and 20. The frequency of app exercise usage was gathered directly through the app to assess the adherence of patients. In addition, we conducted interviews with 5 health professionals for their thoughts on the implementation of the app intervention in standard medical care. We analyzed patients’ self-reported outcomes using linear mixed models (LMMs) and qualitative data with content analysis. Results A total of 100 patients with cancer (74 female) with a mean age of 53.2 years (SD 11.6) participated in the study, of which 25 patients used the app regularly until week 20. LMM analyses revealed improvements in anxiety (P=.04), distress (P<.001), fatigue (P=.01), sleep disturbance (P=.02), quality of life (P=.03), and mindfulness (P<.001) over the course of 20 weeks. Further LMM analyses revealed a larger improvement in distress (P<.001), a moderate improvement in anxiety (P=.001), and a larger improvement in depression (P=.03) in patients with high levels of symptoms at baseline in the respective domains. The interviews revealed that the health professionals perceived the app as a helpful addition to standard care. They also made suggestions for improvements, which could facilitate the implementation of and adherence to such an app. Conclusions This study indicates that a mindfulness and relaxation app for patients with cancer can be a feasible and effective way to deliver a self-care intervention, especially for highly distressed patients. Future studies should investigate if the appeal of the app can be increased with more content, and the effectiveness of such an intervention needs to be tested in a randomized controlled trial.
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Affiliation(s)
- Michael Mikolasek
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Claudia Margitta Witt
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland.,Institute for Social Medicine, Epidemiology and Health Economics, Charité, Universitätsmedizin Berlin, Berlin, Germany.,Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Jürgen Barth
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
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33
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Lunsky Y, Albaum C, Baskin A, Hastings RP, Hutton S, Steel L, Wang W, Weiss J. Group Virtual Mindfulness-Based Intervention for Parents of Autistic Adolescents and Adults. J Autism Dev Disord 2021; 51:3959-3969. [PMID: 33420938 PMCID: PMC7796683 DOI: 10.1007/s10803-020-04835-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2020] [Indexed: 12/05/2022]
Abstract
Mindfulness-based approaches have been shown to be effective in improving the mental health of parents of youth and adults with autism and other developmental disabilities, but prior work suggests that geography and caregiving demands can make in-person attendance challenging. The purpose of this study was to evaluate the feasibility, acceptability and preliminary outcomes of a mindfulness-based group intervention delivered to parents virtually. It was feasible to deliver this manualized intervention. Twenty-one of 39 parents completed the intervention and completers reported high satisfaction ratings. Parents reported reduced levels of distress, maintained at 3-month follow-up, and increased mindfulness. Changes reported following intervention were similar to changes reported in a prior study of parents competing an in person mindfulness group.
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Affiliation(s)
- Y Lunsky
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, 1025 Queen Street West, Toronto, ON, Canada.
- Department of Psychiatry, University of Toronto, Medical Sciences Building, 1 King's College Cir, Toronto, ON, Canada.
| | - C Albaum
- Department of Psychology, York University, Department of Psychology Room 291. Behavioural Sciences Building 4700 Keele Street, Toronto, ON, Canada
| | - A Baskin
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, 1025 Queen Street West, Toronto, ON, Canada
| | - R P Hastings
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, CV4 7AL, UK
- Department of Psychiatry, Centre for Developmental Psychiatry and Psychology, Monash University, Clayton, VIC, 3168, Australia
| | - S Hutton
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, 1025 Queen Street West, Toronto, ON, Canada
| | - L Steel
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, 1025 Queen Street West, Toronto, ON, Canada
| | - W Wang
- Centre for Addiction and Mental Health, 1001 Queen Street West, Toronto, ON, Canada
| | - J Weiss
- Department of Psychology, York University, Department of Psychology Room 291. Behavioural Sciences Building 4700 Keele Street, Toronto, ON, Canada
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Dresler T, Guth AL, Lüpke J, Kropp P. [Psychological treatment of headache in times of COVID-19]. Schmerz 2020; 34:503-510. [PMID: 33030591 PMCID: PMC7543037 DOI: 10.1007/s00482-020-00507-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 08/17/2020] [Accepted: 09/03/2020] [Indexed: 01/20/2023]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has substantially changed life worldwide in 2020. This also influences the psychological treatment options of patients with headache. AIM The present article intends to illustrate the different psychological forms of treatment for headache patients and their implementation during the COVID-19 pandemic. MATERIAL AND METHODS Literature review and case reports. RESULTS Even during the COVID-19 pandemic, psychological treatment enables the increased stress level in headache patients to be counteracted by using cognitive behavioral therapy and relaxation techniques. The changed living conditions are often unfavorable but sometimes also favorable in the course of disease. It can be shown that even during the pandemic, such favorable changes can be used to support patients to cope with their headache. CONCLUSION The digital implementation of psychological approaches makes a major contribution to maintaining psychological treatment of headache patients, so that the individually changed needs can be addressed. With respect to content, stress regulation techniques and increased acceptance gain in importance. Regarding biofeedback there are limitations, which may be overcome by improved technical devices.
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Affiliation(s)
- T Dresler
- Klinik für Psychiatrie und Psychotherapie, Universität Tübingen, Calwerstr. 14, 72076, Tübingen, Deutschland.
- Graduiertenschule & Forschungsnetzwerk LEAD, Universität Tübingen, Tübingen, Deutschland.
| | - A-L Guth
- Migräne- und Kopfschmerzklinik Königstein, Königstein, Deutschland
| | - J Lüpke
- Institut für Medizinische Psychologie und Medizinische Soziologie, Universitätsmedizin Rostock, Rostock, Deutschland
| | - P Kropp
- Institut für Medizinische Psychologie und Medizinische Soziologie, Universitätsmedizin Rostock, Rostock, Deutschland
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Çelik AS, Apay SE. Effect of progressive relaxation exercises on primary dysmenorrhea in Turkish students: A randomized prospective controlled trial. Complement Ther Clin Pract 2020; 42:101280. [PMID: 33310052 DOI: 10.1016/j.ctcp.2020.101280] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 11/14/2020] [Accepted: 11/25/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND A randomized prospective controlled study was conducted concerning the effects of progressive relaxation exercises on the reduction of pain in primary dysmenorrhea. MATERIALS AND METHODS The research control group (CG) consisted of 60 students while the experimental group (EG) consisted of 64 students. The progressive relaxation exercises were self-administered via compact disc (CD) by participants for two menstrual cycles. A descriptive information form, a visual analog scale (VAS) and a dysmenorrhea monitoring form (DMF) were used for data collection. RESULTS The difference between the average first and final post-exercise measurements of the VAS scores of students in the experimental group was statistically significant (p < 0.001), whereas the difference in the control group was not statistically significant (p > 0.05). CONCLUSION Progressive relaxation exercises are an effective method for reducing dysmenorrhea when they are performed on a regular basis.
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Affiliation(s)
- Aslı Sis Çelik
- Atatürk University, Nursing Faculty, Department of Birth, Women Health and Gynecology Nursing, Erzurum, Turkey.
| | - Serap Ejder Apay
- Atatürk University, Faculty of Health Science, Department of Midwifery, Erzurum, Turkey.
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Matis J, Svetlak M, Slezackova A, Svoboda M, Šumec R. Mindfulness-Based Programs for Patients With Cancer via eHealth and Mobile Health: Systematic Review and Synthesis of Quantitative Research. J Med Internet Res 2020; 22:e20709. [PMID: 33196452 PMCID: PMC7704284 DOI: 10.2196/20709] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 09/22/2020] [Accepted: 09/30/2020] [Indexed: 01/07/2023] Open
Abstract
Background eHealth mindfulness-based programs (eMBPs) are on the rise in complex oncology and palliative care. However, we are still at the beginning of answering the questions of how effective eMBPs are and for whom, and what kinds of delivery modes are the most efficient. Objective This systematic review aims to examine the feasibility and efficacy of eMBPs in improving the mental health and well-being of patients with cancer, to describe intervention characteristics and delivery modes of these programs, and to summarize the results of the included studies in terms of moderators, mediators, and predictors of efficacy, adherence, and attrition. Methods In total, 4 databases (PubMed, PsycINFO, Scopus, and Web of Knowledge) were searched using relevant search terms (eg, mindfulness, program, eHealth, neoplasm) and their variations. No restrictions were imposed on language or publication type. The results of the efficacy of eMBPs were synthesized through the summarizing effect estimates method. Results
A total of 29 published papers describing 24 original studies were included in this review. In general, the results indicate that eMBPs have the potential to reduce the levels of stress, anxiety, depression, fatigue, sleep problems, and pain, and improve the levels of mindfulness, posttraumatic growth, and some parameters of general health. The largest median of Cohen d effect sizes were observed in reducing anxiety and depression (within-subject: median −0.38, IQR −0.62 to −0.27; between-group:
median −0.42, IQR −0.58 to −0.22) and facilitating posttraumatic growth (within-subject: median 0.42, IQR 0.35 to 0.48;
between-group: median 0.32, IQR 0.22 to 0.39). The efficacy of eMBP may be comparable with that of parallel, face-to-face
MBPs in some cases. All studies that evaluated the feasibility of eMBPs reported that they are feasible for patients with cancer.
Potential moderators, mediators, and predictors of the efficacy, attrition, and adherence of eMBPs are discussed.
Conclusions Although the effects of the reviewed studies were highly heterogeneous, the review provides evidence that eMBPs are an appropriate way for mindfulness practice to be delivered to patients with cancer. Thus far, existing eMBPs have mostly attempted to convert proven face-to-face mindfulness programs to the eHealth mode. They have not yet fully exploited the potential of eHealth technology.
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Affiliation(s)
- Juraj Matis
- Department of Psychology, Faculty of Arts, Masaryk University, Brno, Czech Republic
| | - Miroslav Svetlak
- Department of Psychology and Psychosomatics, Faculty of Medicine, Masaryk University, Brno, Czech Republic.,Department of Psychiatry, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Alena Slezackova
- Department of Psychology, Faculty of Arts, Masaryk University, Brno, Czech Republic.,Department of Psychology and Psychosomatics, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Marek Svoboda
- Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Rastislav Šumec
- Department of Psychology and Psychosomatics, Faculty of Medicine, Masaryk University, Brno, Czech Republic.,First Department of Neurology, Faculty of Medicine, Masaryk University and St. Anne's University Hospital, Brno, Czech Republic
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Behavioral Medicine Methods in Treatment of Somatic Conditions. BIOMED RESEARCH INTERNATIONAL 2020; 2020:5076516. [PMID: 33204700 PMCID: PMC7655248 DOI: 10.1155/2020/5076516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 08/30/2020] [Accepted: 10/27/2020] [Indexed: 11/26/2022]
Abstract
Background The aim of this article is to present a short review of noninvasive, nonpharmacological treatment methods used in somatic illnesses that fall under the umbrella of approach called behavioral medicine. Methods The narrative review method was applied in the study. Science paper databases, including PubMed, had been used to retrieve papers on therapeutic methods used in clinical setting that meet the broad criteria of behavioral medicine definition as stated in the Charter of International Behavioral Medicine Society Results Main groups of methods, disorders in which they are being employed and their effectiveness, have been identified. Conclusions Behavioral medicine is grouping treatment methods and interventions that hold large potential for clinical setting. Two groups of methods can be distinguished by the scrutiny and level of evidence gathered in their effectiveness assessment; for biofeedback, guided imagery, and hypnosis techniques, comprehensive evidence reports in the framework of U.S. Evidence Synthesis Program exist. Meditation techniques, disclosure therapies, and relaxation methods are less well assessed. Broader employment of behavioral medicine therapies in clinical setting is possible after addressing two major problems in the field, which are deficiencies in quality evidence of effectiveness for many of the methods and their insufficiencies in underlying therapeutic mechanism knowledge.
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Lee EKP, Yeung NCY, Xu Z, Zhang D, Yu CP, Wong SYS. Effect and Acceptability of Mindfulness-Based Stress Reduction Program on Patients With Elevated Blood Pressure or Hypertension: A Meta-Analysis of Randomized Controlled Trials. Hypertension 2020; 76:1992-2001. [PMID: 33131316 DOI: 10.1161/hypertensionaha.120.16160] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The mindfulness-based stress reduction program (MBSR) may reduce blood pressure (BP) in patients with hypertension or elevated BP. However, some important parameters (such as asleep BP) have not been investigated in previous reviews, and a well-conducted meta-analysis is lacking. This meta-analysis investigates the effect and acceptability of MBSR on patients with elevated BP or hypertension. Relevant articles were searched in multiple databases, including MEDLINE, EMBASE, and APA PsycInfo. Included studies were randomized controlled trials that involved patients with an elevated BP, had a control group, and investigated the effect of MBSR. The mean office and out-of-office (including 24-hour, daytime, and asleep) systolic BP and diastolic BP, psychological outcomes (depression/anxiety/stress), and dropout rate were compared between the MBSR arm and the control arm using a random-effects model. Quality assessment was conducted based on the Cochrane risk-of-bias tool. Twelve studies were included, and only one was considered having low risk of bias. MBSR decreased the office systolic BP and diastolic BP by 6.64 and 2.47 mm Hg at postintervention, respectively; the reduction in diastolic BP was sustained until 3 to 6 months after the recruitment. Our meta-analyses did not find a significant reduction in out-of-office BP after MBSR. MBSR reduced depressive, anxiety, and stress symptoms. The dropout rate from MBSR arm was 15% and was similar to that of control arm. The current evidence is limited by lack of high-quality and adequately powered trials with long-term follow-up. Furthermore, out-of-office BP was only reported by few trials.
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Affiliation(s)
- Eric K P Lee
- From the Jockey Club School of Public Health and Primary Care, Faculty of Medicine (E.K.P.L., N.C.Y.Y., Z.X., D.Z., S.Y.S.W.), The Chinese University of Hong Kong
| | - Nelson C Y Yeung
- From the Jockey Club School of Public Health and Primary Care, Faculty of Medicine (E.K.P.L., N.C.Y.Y., Z.X., D.Z., S.Y.S.W.), The Chinese University of Hong Kong
| | - Zijun Xu
- From the Jockey Club School of Public Health and Primary Care, Faculty of Medicine (E.K.P.L., N.C.Y.Y., Z.X., D.Z., S.Y.S.W.), The Chinese University of Hong Kong
| | - Dexing Zhang
- From the Jockey Club School of Public Health and Primary Care, Faculty of Medicine (E.K.P.L., N.C.Y.Y., Z.X., D.Z., S.Y.S.W.), The Chinese University of Hong Kong
| | - Chun-Pong Yu
- Li Ping Medical Library (C.-P.Y.), The Chinese University of Hong Kong
| | - Samuel Y S Wong
- From the Jockey Club School of Public Health and Primary Care, Faculty of Medicine (E.K.P.L., N.C.Y.Y., Z.X., D.Z., S.Y.S.W.), The Chinese University of Hong Kong
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Stein E, Witkiewitz K. Dismantling Mindfulness-Based Programs: A Systematic Review to Identify Active Components of Treatment. Mindfulness (N Y) 2020; 11:2470-2485. [PMID: 36816712 PMCID: PMC9937445 DOI: 10.1007/s12671-020-01444-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Objectives Elucidating the active ingredients of psychological treatments is an important step in the scientific validation of these interventions. Component studies are one way to test which aspects of psychological treatments impact outcomes, or in other words, are the active ingredients of treatment. As research and popular interest in mindfulness-based programs grows, it is important to evaluate the active ingredients of these programs and to continually refine theorized models of the mechanisms of mindfulness. Studying active ingredients may help clarify which elements of mindfulness-based programs are most important for dissemination. Methods We conducted a systematic review of component studies of mindfulness-based programs for adults with psychological conditions. PRISMA guidelines for systematic reviews were followed. Results Eight component studies were identified. These studies dismantled mindfulness-based stress reduction, mindfulness-based cognitive therapy, unified mindfulness, and core mindfulness processes. The eight studies differed with respect to types of programs and populations studied, yet similarities emerged. Notably, acceptance coupled with awareness and mindfulness meditation training may be two promising active ingredients of these different programs. Conclusions Future studies examining mindfulness-based programs should continue to attempt to dismantle active ingredients of treatment and use the findings to update theoretical models of mindfulness.
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Affiliation(s)
- Elena Stein
- Psychology Department, University of New Mexico, MSC 03-2220, Albuquerque NM, 87131,Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico, 2650 Yale Blvd SE, Albuquerque NM, 87106
| | - Katie Witkiewitz
- Psychology Department, University of New Mexico, MSC 03-2220, Albuquerque NM, 87131,Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico, 2650 Yale Blvd SE, Albuquerque NM, 87106
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Spahrkäs SS, Looijmans A, Sanderman R, Hagedoorn M. Beating cancer-related fatigue with the Untire mobile app: Results from a waiting-list randomized controlled trial. Psychooncology 2020; 29:1823-1834. [PMID: 33393199 PMCID: PMC7756868 DOI: 10.1002/pon.5492] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 06/23/2020] [Accepted: 07/10/2020] [Indexed: 11/22/2022]
Abstract
Objective This waiting‐list randomized controlled trial examined the effectiveness of a self‐management mHealth app in improving fatigue and quality of life (QoL) in cancer patients and survivors. Methods Persons with cancer‐related fatigue (CRF) were recruited across four English speaking countries, via social media, and randomized into intervention (n = 519) and control (n = 280) groups. Whereas the intervention group received immediate access to the Untire app, the control group received access only after 12‐weeks. Primary outcomes fatigue severity and interference, and secondary outcome QoL were assessed at baseline, 4, 8, and 12‐weeks. We ran generalized linear mixed models for all outcomes to determine the effects of app access (yes/no), over 12‐weeks, following the intention‐to‐treat principle. Results Compared with the control group, the intervention group showed significantly larger improvements in fatigue severity (d = 0.40), fatigue interference (d = 0.35), and overall QoL on average (d = 0.32) (P's < .01), but not for overall QoL in the past week (P = .07). Sensitivity analyses indicated that participants with medium or high app use benefited most when compared with nonusers and control participants (P's ≤ .02). The intervention effect on fatigue interference was slightly stronger in younger participants (≤56 vs. >56). Effects did not depend on education and cancer status. Reliable change analyses indicated that significantly more people showed full recovery for fatigue in the intervention vs the control group (P's = .02). Conclusions The Untire app can be an effective mHealth solution for cancer patients and survivors with moderate to severe CRF.
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Affiliation(s)
- Simon Sebastian Spahrkäs
- Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Anne Looijmans
- Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Robbert Sanderman
- Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.,Department of Psychology, Health & Technology, University of Twente, Enschede, the Netherlands
| | - Mariët Hagedoorn
- Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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Kwon CY, Kwak HY, Kim JW. Using Mind-Body Modalities via Telemedicine during the COVID-19 Crisis: Cases in the Republic of Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124477. [PMID: 32580396 PMCID: PMC7345492 DOI: 10.3390/ijerph17124477] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 06/19/2020] [Indexed: 12/18/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic affected the world, and its deleterious effects on human domestic life, society, economics, and especially on human mental health are expected to continue. Mental health experts highlighted health issues this pandemic may cause, such as depression, anxiety, obsessive compulsive disorder, and post-traumatic stress disorder. Mind–body intervention, such as mindfulness meditation, has accumulated sufficient empirical evidence supporting the efficacy in improving human mental health states and the use for this purpose has been increasing. Notably, some of these interventions have already been tried in the form of telemedicine or eHealth. Korea, located adjacent to China, was exposed to COVID-19 from a relatively early stage, and today it is evaluated to have been successful in controlling this disease. “The COVID-19 telemedicine center of Korean medicine” has treated more than 20% of the confirmed COVID-19 patients in Korea with telemedicine since 9 March 2020. The center used telemedicine and mind–body modalities (including mindfulness meditation) to improve the mental health of patients diagnosed with COVID-19. In this paper, the telemedicine manual is introduced to provide insights into the development of mental health interventions for COVID-19 and other large-scale disasters in the upcoming new-normal era.
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Affiliation(s)
- Chan-Young Kwon
- Department of Oriental Neuropsychiatry, Dong-eui University College of Korean Medicine, Busan 47227, Korea;
| | - Hui-Yong Kwak
- Department of Neuropsychiatry, Kyung Hee University Korean Medicine Hospital at Gangdong, Seoul 05278, Korea;
| | - Jong Woo Kim
- Department of Neuropsychiatry, Kyung Hee University Korean Medicine Hospital at Gangdong, Seoul 05278, Korea;
- Correspondence:
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Zarifsanaiey N, Jamalian K, Bazrafcan L, Keshavarzy F, Shahraki HR. The effects of mindfulness training on the level of happiness and blood sugar in diabetes patients. J Diabetes Metab Disord 2020; 19:311-317. [PMID: 32550181 DOI: 10.1007/s40200-020-00510-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 02/24/2020] [Indexed: 01/24/2023]
Abstract
Purpose The present study aimed at investigating the effect of mindfulness training on the level of happiness and blood glucose in diabetic patients in Zarghan city, Iran. Methods This quasi-experimental study was conducted in 2018 in Fars province, Iran. 136 diabetic patients who were eligible (had diabetes for more than one year, older than 18 years, willingness to participate in the research, and reside in Zarqan city) were selected based on convenience sampling method. Next the participants were randomly divided into two groups, each comprising 68 individuals. Both of the study samples and statistical analyser were blinded to intervention group (mindfulness training) and control group (without intervention). Before and three month after the intervention the patients' levels of happiness (based on Oxford Happiness Questionnaire), fasting blood sugar (FBS) and Glycated Hemoglobin test (HbA1c) were measured. Results The results indicated that after the sessions, the level of happiness in the Intervention group was significantly higher than the control group (p value <0.001). Also, the level of blood glucose and HbA1c after the sessions was significantly lower in the Intervention group compared to the control group (p value<0.001, p value = 0.004). After the intervention, there was a significant correlation between mean blood glucose levels and mean HbA1c levels in the Intervention group and their level of happiness (p value<0.01 and p value<0.001). Conclusion The findings revealed that the mindfulness-based educational intervention can increase happiness in people with diabetes and regulate their blood glucose.
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Affiliation(s)
- Nahid Zarifsanaiey
- Department of E-learning, Virtual School, Comprehensive Center of Excellence for e-Learning in Medical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Medical Education, Virtual university of Medical Sciences, Tehran, Iran
| | | | - Leila Bazrafcan
- Clinical Education Research Centre, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Hadi Raeisi Shahraki
- Department of Epidemiology and Biostatistics, Faculty of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran
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Spahrkäs SS, Looijmans A, Sanderman R, Hagedoorn M. Beating Cancer-Related Fatigue With the Untire Mobile App: Protocol for a Waiting List Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e15969. [PMID: 32130185 PMCID: PMC7055831 DOI: 10.2196/15969] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 11/20/2019] [Accepted: 11/26/2019] [Indexed: 01/19/2023] Open
Abstract
Background Many cancer patients and survivors worldwide experience disabling fatigue as the main side effect of their illness and the treatments involved. Face-to-face therapy is effective in treating cancer-related fatigue (CRF), but it is also resource-intensive. Offering a self-management program via a mobile phone app (ie, the Untire app), based on elements of effective face-to-face treatments, might increase the number of patients receiving adequate support for fatigue and decrease care costs. Objective The aim of this protocol is to describe a randomized controlled trial (RCT) to assess the effectiveness of the Untire app in reducing fatigue in cancer patients and survivors after 12 weeks of app use as compared with a waiting list control group. Substudies nested within this trial include questions concerning the reach and costs of online recruitment and uptake and usage of the Untire app. Methods The Untire app study is a waiting list RCT targeting cancer patients and survivors who experience moderate to severe fatigue via social media (Facebook and Instagram) across 4 English-speaking countries (Australia, Canada, the United Kingdom, and the United States). The Untire app includes psychoeducation and exercises concerning energy conservation, activity management, optimizing restful sleep, mindfulness-based stress reduction, psychosocial support, cognitive behavioral therapy, and physical activity. After randomization, participants in the intervention group could access the Untire app immediately, whereas control participants had no access to the Untire app until the primary follow-up assessment at 12 weeks. Participants completed questionnaires at baseline before randomization and after 4, 8, 12, and 24 weeks. The study outcomes are fatigue (primary) and quality of life (QoL; secondary). Potential moderators and mediators of the hypothesized treatment effect on levels of fatigue and QoL were also assessed. Link clicks and app activation are used to assess reach and uptake, respectively. Log data are used to explore the characteristics of app use. Sample size calculations for the primary outcome showed that we needed to include 164 participants with complete 12-week measures both in the intervention and the control groups. The intention-to-treat approach is used in the primary analyses, which refers to analyzing all participants regardless of their app use. Results Participants were recruited from March to October 2018. The last participant completed the 24-week assessment in March 2019. Conclusions This mobile health (mHealth) RCT recruited participants online in multiple countries to examine the uptake and effectiveness of the Untire self-management app to reduce CRF. Many advantages of mHealth apps are assumed, such as the immediate access to the app, the low thresholds to seek support, and the absence of contact with care professionals that will reduce costs. If found effective, this app can easily be offered worldwide to patients experiencing CRF. Trial Registration Netherlands Trial Register NL6642; https://www.trialregister.nl/trial/6642. International Registered Report Identifier (IRRID) DERR1-10.2196/15969
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Affiliation(s)
- Simon S Spahrkäs
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Anne Looijmans
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Robbert Sanderman
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.,Department of Psychology, Health & Technology, University of Twente, Enschede, Netherlands
| | - Mariët Hagedoorn
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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Apolinário-Hagen J, Drüge M, Fritsche L. Cognitive Behavioral Therapy, Mindfulness-Based Cognitive Therapy and Acceptance Commitment Therapy for Anxiety Disorders: Integrating Traditional with Digital Treatment Approaches. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1191:291-329. [DOI: 10.1007/978-981-32-9705-0_17] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Lippmann M, Laudel H, Heinzle M, Narciss S. Relating Instructional Design Components to the Effectiveness of Internet-Based Mindfulness Interventions: A Critical Interpretive Synthesis. J Med Internet Res 2019; 21:e12497. [PMID: 31774413 PMCID: PMC6906627 DOI: 10.2196/12497] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 08/17/2019] [Accepted: 09/26/2019] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Internet-based mindfulness interventions are a promising approach to address challenges in the dissemination and implementation of mindfulness interventions, but it is unclear how the instructional design components of such interventions are associated with intervention effectiveness. OBJECTIVE The objective of this study was to identify the instructional design components of the internet-based mindfulness interventions and provide a framework for the classification of those components relative to the intervention effectiveness. METHODS The critical interpretive synthesis method was applied. In phase 1, a strategic literature review was conducted to generate hypotheses for the relationship between the effectiveness of internet-based mindfulness interventions and the instructional design components of those interventions. In phase 2, the literature review was extended to systematically explore and revise the hypotheses from phase 1. RESULTS A total of 18 studies were identified in phase 1; 14 additional studies were identified in phase 2. Of the 32 internet-based mindfulness interventions, 18 were classified as more effective, 11 as less effective, and only 3 as ineffective. The effectiveness of the interventions increased with the level of support provided by the instructional design components. The main difference between effective and ineffective interventions was the presence of just-in-time information in the form of reminders. More effective interventions included more supportive information (scores: 1.91 in phases 1 and 2) than less effective interventions (scores: 1.00 in phase 1 and 1.80 in phase 2), more part-task practice (scores: 1.18 in phase 1 and 1.60 in phase 2) than less effective interventions (scores: 0.33 in phase 1 and 1.40 in phase 2), and provided more just-in-time information (scores: 1.35 in phase 1 and 1.67 in phase 2) than less effective interventions (scores: 0.83 in phase 1 and 1.60 in phase 2). The average duration of more effective, less effective, and ineffective interventions differed for the studies of phase 1, with more effective interventions taking up more time (7.45 weeks) than less effective (4.58 weeks) or ineffective interventions (3 weeks). However, this difference did not extend to the studies of phase 2, with comparable average durations of effective (5.86 weeks), less effective (5.6 weeks), and ineffective (7 weeks) interventions. CONCLUSIONS Our results suggest that to be effective, internet-based mindfulness interventions must contain 4 instructional design components: formal learning tasks, supportive information, part-task practice, and just-in-time information. The effectiveness of the interventions increases with the level of support provided by each of these instructional design components.
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Affiliation(s)
- Marie Lippmann
- Department of Psychology, California State University, Chico, CA, United States
| | - Helena Laudel
- Psychology of Learning and Instruction, Faculty of Psychology - School of Science, Technische Universität Dresden, Dresden, Germany
| | - Marlene Heinzle
- Department of Media, Cognition and Communication, Faculty of Humanities, University of Copenhagen, Copenhagen, Denmark
| | - Susanne Narciss
- Psychology of Learning and Instruction, Faculty of Psychology - School of Science, Technische Universität Dresden, Dresden, Germany
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Walsh KM, Saab BJ, Farb NA. Effects of a Mindfulness Meditation App on Subjective Well-Being: Active Randomized Controlled Trial and Experience Sampling Study. JMIR Ment Health 2019; 6:e10844. [PMID: 30622094 PMCID: PMC6329416 DOI: 10.2196/10844] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 09/23/2018] [Accepted: 11/01/2018] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Mindfulness training (MT) includes a variety of contemplative practices aimed at promoting intentional awareness of experience, coupled with attitudes of nonjudgment and curiosity. Following the success of 8-week, manualized group interventions, MT has been implemented in a variety of modalities, including smartphone apps that seek to replicate the success of group interventions. However, although smartphone apps are scalable and accessible to a wider swath of population, their benefits remain largely untested. OBJECTIVE This study aimed to investigate a newly developed MT app called Wildflowers, which was codeveloped with the laboratory for use in mindfulness research. It was hypothesized that 3 weeks of MT through this app would improve subjective well-being, attentional control, and interoceptive integration, albeit with weaker effects than those published in the 8 week, manualized group intervention literature. METHODS Undergraduate students completed 3 weeks of MT with Wildflowers (n=45) or 3 weeks of cognitive training with a game called 2048 (n=41). State training effects were assessed through pre- and postsession ratings of current mood, stress level, and heart rate. Trait training effects were assessed through pre- and postintervention questionnaires canvassing subjective well-being and behavioral task measures of attentional control and interoceptive integration. State and trait training data were analyzed in a multilevel model using emergent latent factors (acceptance, awareness, and openness) to summarize the trait questionnaire battery. RESULTS Analyses revealed both state and trait effects specific to MT; participants engaging in MT demonstrated improved mood (r=.14) and a reduction of stress (r=-.13) immediately after each training session compared with before the training session and decreased postsession stress over 3 weeks (r=-.08). In addition, MT relative to cognitive training resulted in greater improvements in attentional control (r=-.24). Interestingly, both groups demonstrated increased subjective ratings of awareness (r=.28) and acceptance (r=.23) from pre- to postintervention, with greater changes in acceptance for the MT group trending (r=.21). CONCLUSIONS MT, using a smartphone app, may provide immediate effects on mood and stress while also providing long-term benefits for attentional control. Although further investigation is warranted, there is evidence that with continued usage, MT via a smartphone app may provide long-term benefits in changing how one relates to their inner and outer experiences. TRIAL REGISTRATION ClinicalTrials.gov NCT03783793; https://clinicaltrials.gov/ct2/show/NCT03783793 (Archived by WebCite at http://www.webcitation.org/75EF2ehst).
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Affiliation(s)
- Kathleen Marie Walsh
- Department of Psychological Clinical Science, University of Toronto Scarborough, Toronto, ON, Canada
| | - Bechara J Saab
- Mobio Interactive Inc, Biomedical Zone, St. Michael's Hospital, Toronto, ON, Canada.,Preclinical Laboratory for Translational Research into Affective Disorders, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.,Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland.,Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Norman As Farb
- Department of Psychology, University of Toronto Mississauga, Mississauga, ON, Canada
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Mikolasek M, Witt CM, Barth J. Adherence to a Mindfulness and Relaxation Self-Care App for Cancer Patients: Mixed-Methods Feasibility Study. JMIR Mhealth Uhealth 2018; 6:e11271. [PMID: 30522990 PMCID: PMC6302233 DOI: 10.2196/11271] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 09/15/2018] [Accepted: 09/19/2018] [Indexed: 01/20/2023] Open
Abstract
Background Cancer is highly prevalent worldwide and can cause high levels of distress in patients, which is often neglected in medical care. Smartphone apps are readily available and therefore seem promising to deliver distress-reducing interventions such as mindfulness and relaxation programs. Objective This study aimed to evaluate the feasibility of a mindfulness and relaxation app for cancer patients. We looked at characteristics of participating patients in a mobile health (mHealth) study, including adherence to the app intervention, predictors for adherence, and patients’ feedback regarding the app. Methods In this prospective observational study with a mixed-methods approach, cancer patients received a mindfulness and relaxation self-care app. Cancer patients were recruited online and through hospitals in Switzerland. We assessed self-reported measures (eg, quality of life, anxiety, depressive symptoms, openness to experience, resistance to change) at baseline, and the app gathered data on patients’ practicing time. With 8 semistructured interviews, we obtained patients’ feedback about the app and recommendations for improvements. We looked at 3 dimensions of the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework (reach, adoption, and maintenance) and analyzed data for adherence for the first 10 weeks of the app intervention. We report descriptive statistics for patient characteristics and app use. For the prediction of adherence, we used Kaplan-Meier analyses with log-rank tests and a Cox proportional hazards regression. Results Data from 100 cancer patients (74 female) showed that 54 patients were using the app exercises continuously until week 10. In continuous app users, the median number of exercises per week dropped from 4 (interquartile range, IQR 1-7) at week 1 to a median of 2 (IQR 1-4) at week 10. Our analyses revealed 4 significant predictors for better adherence: female gender, higher openness to experience, higher resistance to change, and more depressive symptoms. Interviews revealed that the patients generally were satisfied with the app but also made suggestions on how to improve it. Conclusions Our study indicates that a mindfulness and relaxation mHealth intervention for cancer patients is feasible with acceptable adherence and largely positive feedback from patients. Trial Registration German Clinical Trials Register DRKS00010481; https://www.drks.de/drks_web/navigate.do?navigation Id=trial.HTML&TRIAL_ID=DRKS00010481 (Archived by WebCite at http://www.webcitation.org/73xGE1B0P)
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Affiliation(s)
- Michael Mikolasek
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Claudia M Witt
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland.,Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Jürgen Barth
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
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Russell L, Ugalde A, Orellana L, Milne D, Krishnasamy M, Chambers R, Austin DW, Livingston PM. A pilot randomised controlled trial of an online mindfulness-based program for people diagnosed with melanoma. Support Care Cancer 2018; 27:2735-2746. [DOI: 10.1007/s00520-018-4574-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 11/22/2018] [Indexed: 11/30/2022]
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Abstract
Medical progress, the improvement of general living conditions, and an increase in life expectancy have led to an increase in the general prevalence of oncologic disease. More importantly, more and more patients survive cancer or live with the disease for long periods of time. While the battle for survivorship is continuously being fought, improving patients' quality of life has come to the fore. Psychosocial issues may modulate the course of the disease, but mainly have a deep impact on patients' physical and mental wellbeing. Psycho-oncology has risen as a relatively new interdisciplinary field with the aim of addressing these issues and providing support for patients confronting numerous challenges throughout the different stages of the disease. In this article, we provide an overview of the current knowledge of body-mind interactions in cancer and an outline of the broad spectrum of psycho-oncologic care, with a special focus on the treatment of pain, fatigue, sexual issues, and fear of progression.
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Chadi N, Weisbaum E, Malboeuf-Hurtubise C, Ahola Kohut S, Viner C, Kaufman M, Locke J, Vo DX. Can the Mindful Awareness and Resilience Skills for Adolescents (MARS-A) Program Be Provided Online? Voices from the Youth. CHILDREN (BASEL, SWITZERLAND) 2018; 5:children5090115. [PMID: 30154368 PMCID: PMC6162431 DOI: 10.3390/children5090115] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 08/23/2018] [Accepted: 08/23/2018] [Indexed: 01/13/2023]
Abstract
Mindfulness-based interventions (MBIs) have been shown to improve health and well-being in adolescents with chronic illnesses. Because they are most often delivered in person in a group setting, there are several barriers that limit access to MBIs for youth with limited mobility or who cannot access in-person MBIs in their communities. The objective of this study was to determine if eHealth is a viable platform to increase accessibility to MBIs for teens with chronic illnesses. This study reports the qualitative results of a mixed method randomized trial describing the experience of the Mindful Awareness and Resilience Skills for Adolescents (MARS-A) program, an eight-week MBI, delivered either in person or via eHealth. Participants were adolescents between the ages of 13 and 18 with a chronic illness recruited at a tertiary pediatric hospital in Toronto, Canada. Individual semi-structured post-participation audio-video interviews were conducted by a research assistant. A multiple-pass inductive process was used to review interview transcripts and interpret emergent themes from the participants’ lived experiences. Fifteen participants (8 online and 7 in person) completed post-participation interviews. Four distinct themes emerged from participants in both groups: Creation of a safe space, fostering peer support and connection, integration of mindfulness skills into daily life, and improved well-being through the application of mindfulness. Direct quotations representative of those four themes are reported. Results from this study suggest that eHealth delivery of an adapted MBI for adolescents with chronic illnesses may be an acceptable and feasible mode of delivery for MBIs in this population. EHealth should be considered in future studies of MBIs for adolescents with chronic illnesses as a promising avenue to increase access to MBIs for youth who might not be able to access in-person programs.
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Affiliation(s)
- Nicholas Chadi
- Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
| | - Elli Weisbaum
- Institute of Medical Sciences, University of Toronto, 1 King's College Circle, Room 2374, Toronto, ON M5S 1A8, Canada.
| | | | - Sara Ahola Kohut
- Department of Psychiatry, Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON M5G 1X8, Canada.
| | - Christine Viner
- Department of Pediatrics, Downstate Medical Center, State University of New York, 450 Clarkson Ave, Brooklyn, NY 11203, USA.
| | - Miriam Kaufman
- Division of Adolescent Medicine, Department of Pediatrics, Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON M5G 1X8, Canada.
| | - Jake Locke
- Department of Child and Adolescent Psychiatry, British Columbia Children's Hospital, University of British Columbia, Vancouver, BCV6H 3N1, Canada.
| | - Dzung X Vo
- Division of Adolescent Health and Medicine, Department of Pediatrics, BC Children's Hospital, University of British Columbia, 4480 Oak St, Vancouver, BC V6H 3N1, Canada.
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