1
|
Ouyang X, Ye X, Liu X, Zhang H, Huang S, Fan Y, Lin Y. Effects of kangaroo mother care combined with nurse-assisted mindfulness training for reducing stress among mothers of preterm infants hospitalized in the NICU: a randomized controlled trial. BMC Pediatr 2024; 24:628. [PMID: 39358677 PMCID: PMC11446036 DOI: 10.1186/s12887-024-05075-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 09/10/2024] [Indexed: 10/04/2024] Open
Abstract
BACKGROUND Kangaroo mother care (KMC) can have a positive effect on the mental well-being of a mother. However, there are specific challenges associated with the process that may contribute to increased anxiety for the mother. By integrating nurse-assisted mindfulness training alongside KMC guidance, nurses may effectively alleviate maternal stress to a greater extent. METHODS A single-centre randomized controlled trial was conducted to investigate the effects of KMC combined with nurse-assisted mindfulness training. The study included preterm infants with a gestational age of less than 32 weeks or a birth weight of less than 1500 g and their mothers, who were randomly divided into two groups. The intervention group consisted of mothers who received KMC combined with nurse-assisted mindfulness training for 14 days. The control group comprised mothers who received only KMC for 14 days. Data from both groups were collected and compared for analysis. RESULTS Forty-seven infants and their mothers were included in the intervention group, whereas 44 pairs were included in the control group. After the intervention, the parental stressor scale scores for the neonatal intensive care unit (PSS: NICU) (3), PSS: NICU (4), and Hospital Anxiety and Depression Scale (HADS) scores for the intervention group were lower than those for the control group, whereas the Five Facet Mindfulness Questionnaire (FFMQ) (1), FFMQ (4), and FFMQ (5) scores for the intervention group were higher. The degree of change in the PSS: NICU and HADS scores was inversely correlated with the degree of change in the FFMQ score. The breast milk feed rate and weight gain rate were greater in the intervention group than in the control group. No adverse reactions were observed in either group. CONCLUSIONS Kangaroo mother care combined with nurse-assisted mindfulness training is an acceptable, feasible, and effective procedure for reducing anxiety in mothers of preterm infants in the NICU, with potential benefits for the short-term prognosis of these infants. TRIAL REGISTRATION Chinese Clinical Trial Registry, ChiCTR1900023697, registered on June 8, 2019, retrospectively registered.
Collapse
Affiliation(s)
- Xia Ouyang
- Department of Neonatology, Fujian Children's Hospital, Fujian Branch of Shanghai Children's Medical Center, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
- Department of Neonatology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Xin Ye
- International Psychological Consultant Federation (IPCF) Certified Psychological Counselor, School of Health, Fujian Medical University, Fuzhou, China
| | - Xianping Liu
- Department of Neonatology, Fujian Children's Hospital, Fujian Branch of Shanghai Children's Medical Center, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Haihong Zhang
- Department of Neonatology, Fujian Children's Hospital, Fujian Branch of Shanghai Children's Medical Center, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Shaoru Huang
- Department of Neonatology, Fujian Children's Hospital, Fujian Branch of Shanghai Children's Medical Center, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Yanfang Fan
- Department of Neonatology, Fujian Children's Hospital, Fujian Branch of Shanghai Children's Medical Center, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.
- Department of Neonatology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.
| | - Yunfeng Lin
- Department of Neonatology, Fujian Children's Hospital, Fujian Branch of Shanghai Children's Medical Center, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.
- Department of Neonatology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.
| |
Collapse
|
2
|
Atefi GL, Koh WQ, Kohl G, Seydavi M, Swift JK, Akbari M, de Vugt ME. Adherence to Online Interventions for Family Caregivers of People With Dementia: A Meta-Analysis and Systematic Review. Am J Geriatr Psychiatry 2024; 32:1271-1291. [PMID: 38735829 DOI: 10.1016/j.jagp.2024.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 04/13/2024] [Accepted: 04/15/2024] [Indexed: 05/14/2024]
Abstract
OBJECTIVE Online interventions hold promise in supporting the well-being of family caregivers and enhancing the quality of care they provide for individuals with long-term or chronic conditions. However, dropout rates from support programs among specific groups of caregivers, such as caregivers of people with dementia, pose a challenge. Focused reviews are needed to provide more accurate insights and estimates in this specific research area. METHODS A meta-analysis of dropout rates from available online interventions for family caregivers of people with dementia was conducted to assess treatment acceptability. A systematic search yielded 18 studies involving 1,215 caregivers. RESULTS The overall pooled dropout rate was 18.4%, with notable heterogeneity indicating varied intervention adherence. Interventions incorporating human contact, interactive features, and personalization strategies for specific types and stages of dementia predicted significantly lower dropout rates. Methodological assessment revealed variability in study quality. CONCLUSION Findings support the effectiveness of social support, personalization strategies, and co-design in enhancing intervention adherence among dementia family caregivers. Further research is needed to explore factors influencing dropout rates and conduct robust trials to refine the implementation of future interventions.
Collapse
Affiliation(s)
- Golnaz L Atefi
- Department of Psychiatry and Neuropsychology, Alzheimer Centre Limburg (GLA, MEV), Maastricht University, Maastricht, The Netherlands.
| | - Wei Qi Koh
- School of Health and Rehabilitation Sciences (WQK), The University of Queensland, Brisbane, Australia
| | - Gianna Kohl
- Research Department of Clinical (GK), Educational and Health Psychology, University College London, London, UK
| | - Mohammad Seydavi
- Department of Clinical Psychology (MS, MA), Faculty of Psychology and Education, Kharazmi University, Tehran, Iran
| | - Joshua K Swift
- Department of Psychology (JKS), Idaho State University, 921 S. 8th St, Pocatello, ID
| | - Mehdi Akbari
- Department of Clinical Psychology (MS, MA), Faculty of Psychology and Education, Kharazmi University, Tehran, Iran.
| | - Marjolein E de Vugt
- Department of Psychiatry and Neuropsychology, Alzheimer Centre Limburg (GLA, MEV), Maastricht University, Maastricht, The Netherlands
| |
Collapse
|
3
|
Kishita N, Gould RL, McCracken LM, Khondoker M, Turner DA, Ashford PA, Flanagan E, Czyznikowska B, Richmond E, Riggey M, Trucco AP, Hammond M, Nautiyal A, Farquhar M. The clinical and cost effectiveness of internet-delivered self-help Acceptance and Commitment Therapy for family carers of people with dementia (iACT4CARERS): Study protocol for a randomised controlled trial with ethnically diverse family carers. Contemp Clin Trials 2024; 146:107685. [PMID: 39277168 DOI: 10.1016/j.cct.2024.107685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 06/27/2024] [Accepted: 09/09/2024] [Indexed: 09/17/2024]
Abstract
BACKGROUND Following the successful completion of feasibility and acceptability studies of internet-delivered self-help Acceptance and Commitment Therapy for family carers of people with dementia (iACT4CARERS), a full-scale randomised controlled trial (RCT) evaluating its clinical and cost effectiveness will be conducted. This paper describes the design and protocol for a multi-site, parallel, single-blind, 2-arm RCT evaluating the clinical and cost effectiveness of iACT4CARERS plus treatment-as-usual (TAU) in comparison to TAU alone for reducing anxiety in family carers of people with dementia. METHODS 496 family carers aged ≥18 years, who are caring for a person with dementia, will be recruited from national healthcare services, general practices and community groups in England. Participants randomised to the intervention arm will receive iACT4CARERS over 12 weeks. Participants will complete outcome measures at baseline (0 weeks) and at 12-weeks and 24-weeks post-randomisation. The primary outcome and timepoint will be anxiety at 12 weeks. Secondary outcomes will include psychological flexibility, depression, and cost-effectiveness (cost per quality adjusted life years). Primary analyses will be by intention-to-treat and data will be analysed using linear mixed models. Fidelity and quality of implementation will be assessed and contextual factors associated with variation in outcomes identified in a process evaluation. CONCLUSION If iACT4CARERS is found to be effective and affordable, this self-help intervention, including minimal contact with minimally trained therapists, has the potential to be rolled out widely within healthcare services in the UK, reducing inequality in access to psychological services among this population. CLINICAL TRIALS REGISTRATION ISRCTN registry identifier ISRCTN45995725.
Collapse
Affiliation(s)
- Naoko Kishita
- School of Health Sciences, University of East Anglia, Norwich, United Kingdom.
| | - Rebecca L Gould
- Division of Psychiatry, University College London, London, United Kingdom.
| | | | - Mizanur Khondoker
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom.
| | - David A Turner
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom.
| | - Polly-Anna Ashford
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom.
| | - Emma Flanagan
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom.
| | - Barbara Czyznikowska
- Centre for Ethnic Health Research, University of Leicester, Leicester, United Kingdom.
| | - Erica Richmond
- Norfolk and Suffolk NHS Foundation Trust, Norwich, United Kingdom.
| | - Megan Riggey
- School of Health Sciences, University of East Anglia, Norwich, United Kingdom.
| | - Ana Paula Trucco
- School of Health Sciences, University of East Anglia, Norwich, United Kingdom.
| | - Matthew Hammond
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom.
| | | | - Morag Farquhar
- School of Health Sciences, University of East Anglia, Norwich, United Kingdom.
| |
Collapse
|
4
|
Sparacio A, IJzerman H, Ropovik I, Giorgini F, Spiessens C, Uchino BN, Landvatter J, Tacana T, Diller SJ, Derrick JL, Segundo J, Pierce JD, Ross RM, Francis Z, LaBoucane A, Ma-Kellams C, Ford MB, Schmidt K, Wong CC, Higgins WC, Stone BM, Stanley SK, Ribeiro G, Fuglestad PT, Jaklin V, Kübler A, Ziebell P, Jewell CL, Kovas Y, Allahghadri M, Fransham C, Baranski MF, Burgess H, Benz ABE, DeSousa M, Nylin CE, Brooks JC, Goldsmith CM, Benson JM, Griffin SM, Dunne S, Davis WE, Watermeyer TJ, Meese WB, Howell JL, Standiford Reyes L, Strickland MG, Dickerson SS, Pescatore S, Skakoon-Sparling S, Wunder ZI, Day MV, Brenton S, Linden AH, Hawk CE, O'Brien LV, Urgyen T, McDonald JS, van der Schans KL, Blocker H, Ng Tseung-Wong C, Jiga-Boy GM. Self-administered mindfulness interventions reduce stress in a large, randomized controlled multi-site study. Nat Hum Behav 2024; 8:1716-1725. [PMID: 38862815 PMCID: PMC11420060 DOI: 10.1038/s41562-024-01907-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 05/02/2024] [Indexed: 06/13/2024]
Abstract
Mindfulness witnessed a substantial popularity surge in the past decade, especially as digitally self-administered interventions became available at relatively low costs. Yet, it is uncertain whether they effectively help reduce stress. In a preregistered (OSF https://doi.org/10.17605/OSF.IO/UF4JZ ; retrospective registration at ClinicalTrials.gov NCT06308744 ) multi-site study (nsites = 37, nparticipants = 2,239, 70.4% women, Mage = 22.4, s.d.age = 10.1, all fluent English speakers), we experimentally tested whether four single, standalone mindfulness exercises effectively reduced stress, using Bayesian mixed-effects models. All exercises proved to be more efficacious than the active control. We observed a mean difference of 0.27 (d = -0.56; 95% confidence interval, -0.43 to -0.69) between the control condition (M = 1.95, s.d. = 0.50) and the condition with the largest stress reduction (body scan: M = 1.68, s.d. = 0.46). Our findings suggest that mindfulness may be beneficial for reducing self-reported short-term stress for English speakers from higher-income countries.
Collapse
Affiliation(s)
- Alessandro Sparacio
- LIP/PC2s, Université Grenoble Alpes, Grenoble, France.
- School of Psychology, Swansea University, Swansea, UK.
- Singapore Institute for Clinical Sciences (SICS), A*STAR, Singapore, Singapore.
| | - Hans IJzerman
- LIP/PC2s, Université Grenoble Alpes, Grenoble, France.
- Annecy Behavioral Science Lab, Saint-Jorioz, France.
- Institut Universitaire de France, Paris, France.
| | - Ivan Ropovik
- Institute of Psychology, Czech Academy of Sciences, Prague, Czech Republic.
- Faculty of Education, Institute for Research and Development of Education, Charles University, Prague, Czech Republic.
- Centre of Social and Psychological Sciences, Slovak Academy of Sciences, Štefánikova, Bratislava, Slovakia.
| | - Filippo Giorgini
- Department of Economics, Management and Statistics (DEMS), University of Milano-Bicocca, Milan, Italy
| | | | - Bert N Uchino
- Department of Psychology, College of Social and Behavioral Science, University of Utah, Salt Lake City, UT, USA
| | - Joshua Landvatter
- Department of Psychology, College of Social and Behavioral Science, University of Utah, Salt Lake City, UT, USA
| | - Tracey Tacana
- Department of Psychology, College of Social and Behavioral Science, University of Utah, Salt Lake City, UT, USA
| | - Sandra J Diller
- Private University Seeburg Castle, Seekirchen am Wallersee, Austria
- LMU Munich, Munich, Germany
| | | | | | | | - Robert M Ross
- School of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | - Zoë Francis
- University of the Fraser Valley, Abbotsford, British Colombia, Canada
| | - Amanda LaBoucane
- University of the Fraser Valley, Abbotsford, British Colombia, Canada
| | | | - Maire B Ford
- Psychology department, Loyola Marymount University, Los Angeles, CA, USA
| | | | | | - Wendy C Higgins
- School of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | - Bryant M Stone
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Samantha K Stanley
- Australian National University, Canberra, Australian Capital Territory, Australia
| | - Gianni Ribeiro
- School of Law and Justice, The University of Southern Queensland, Ipswich, Queensland, Australia
| | | | - Valerie Jaklin
- Department of Psychology, University of Würzburg, Würzburg, Germany
| | - Andrea Kübler
- Department of Psychology, University of Würzburg, Würzburg, Germany
| | - Philipp Ziebell
- Department of Psychology, University of Würzburg, Würzburg, Germany
| | | | | | | | | | | | - Hannah Burgess
- Pennsylvania Western University California, California, PA, USA
| | | | | | - Catherine E Nylin
- Department of Social and Behavioral Sciences, Glendale Community College, Glendale, AZ, USA
| | - Janae C Brooks
- Department of Social and Behavioral Sciences, Glendale Community College, Glendale, AZ, USA
| | - Caitlyn M Goldsmith
- Department of Social and Behavioral Sciences, Glendale Community College, Glendale, AZ, USA
| | | | | | | | | | - Tam J Watermeyer
- Northumbria University, Newcastle upon Tyne, UK
- University of Edinburgh, Edinburgh, UK
| | | | | | | | | | | | | | | | | | - Martin V Day
- Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Shawna Brenton
- Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Audrey H Linden
- Centre for Research in Autism and Education, Institute of Education, University College London, London, UK
- Department of Psychology and Counselling, The Open University, Milton Keynes, UK
| | | | - Léan V O'Brien
- University of Canberra, Canberra, Australian Capital Territory, Australia
| | | | | | | | | | | | | |
Collapse
|
5
|
Wozniak JD, Huang H. Emotional Eating in Primary Care: Considerations for Assessment and Management. Harv Rev Psychiatry 2024; 32:166-172. [PMID: 39194425 DOI: 10.1097/hrp.0000000000000405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/29/2024]
Abstract
LEARNING OBJECTIVES After participating in this CME activity, the psychiatrist should be better able to:• Describe how to identify and address emotional eating in the primary care setting. ABSTRACT Emotional eating (i.e., eating in response to negative emotional states and stress) is a highly prevalent concern within primary care settings. It is associated with myriad health issues such as the experience of overweight or obesity, increased difficulty losing weight and sustaining weight loss, various eating disorders, diabetes, and heart disease. Given the effects of emotional eating on patient health goals regarding weight loss or management, it is imperative to incorporate interventions that address emotional underpinnings alongside traditional, behaviorally based weight-loss treatment. Ensuring that primary care providers, who represent pivotal frontline touch points for patients interested in weight-related treatment, can identify emotional eating is an important first step in supporting these patients' goals. The primary purpose of this paper is to provide background information and practical guidance for addressing emotional eating in the primary care setting. We summarize theorized biological and psychological mechanisms that underlie emotional eating, and review traditional (i.e., psychological) interventions, with special consideration for adapting available treatments for use in primary care contexts.
Collapse
Affiliation(s)
- Jana DeSimone Wozniak
- From Harvard Medical School (Drs. Wozniak and Huang); Cambridge Health Alliance, Department of Psychiatry, Cambridge, MA (Drs. Wozniak and Huang)
| | | |
Collapse
|
6
|
Wang Q, Luan Y, Liu D, Dai J, Wang H, Zhang Y, Wang S, Dong X, Bi H. Guided self-help mindfulness-based intervention for increasing psychological resilience and reducing job burnout in psychiatric nurses: A randomized controlled trial. Int J Nurs Pract 2024; 30:e13204. [PMID: 37727093 DOI: 10.1111/ijn.13204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 08/30/2023] [Accepted: 09/01/2023] [Indexed: 09/21/2023]
Abstract
AIMS The present study aimed to explore the effects of a guided self-help mindfulness intervention on psychological resilience and job burnout among psychiatric nurses. BACKGROUND Psychiatric nurses work in challenging and potentially high stress settings. Mindfulness interventions can improve psychological resilience and reduce job burnout of nurses. However, face-to-face delivery of mindfulness interventions may be inconvenient for individuals. Guided self-help interventions may be more accessible. METHODS This randomized controlled trial was conducted from January to August 2022. One hundred and eighteen psychiatric nurses were randomized into the intervention and control groups. The individuals in the intervention group received an 8-week guided self-help mindfulness intervention, while the individuals in the control group received a psycho-educational brochure. The Five Facet Mindfulness Questionnaire, the Connor-Davidson Resilience Scale and the Maslach Burnout Inventory-Human Services Survey were used to evaluate the levels of mindfulness, psychological resilience and job burnout, respectively. RESULTS After an 8-week intervention, compared with the control group, the levels of mindfulness and psychological resilience were higher, while the level of job burnout was lower in the intervention group. CONCLUSIONS The guided self-help mindfulness intervention can improve psychological resilience and reduce job burnout among psychiatric nurses.
Collapse
Affiliation(s)
- Qi Wang
- Department of Psychiatry and Psychology, General Hospital of Northern Theater Command, Shenyang, Liaoning, China
| | - Yue Luan
- Third Hospital of Daqing, Daqing, Heilongjiang, China
| | - Dandan Liu
- Third Hospital of Daqing, Daqing, Heilongjiang, China
| | - Jiali Dai
- Third Hospital of Daqing, Daqing, Heilongjiang, China
| | - Haina Wang
- Third Hospital of Daqing, Daqing, Heilongjiang, China
| | - Yang Zhang
- Third Hospital of Daqing, Daqing, Heilongjiang, China
| | - Shuang Wang
- Third Hospital of Daqing, Daqing, Heilongjiang, China
| | - Xiaomei Dong
- Department of Psychiatry and Psychology, General Hospital of Northern Theater Command, Shenyang, Liaoning, China
| | - Hongsheng Bi
- Third Hospital of Daqing, Daqing, Heilongjiang, China
| |
Collapse
|
7
|
Kotera Y, Beaumont J, Edwards AM, Cotterill M, Kirkman A, Tofani AC, McPhilbin M, Takhi S, Barnes K, Todowede O, Ingall BR, Asano K, Arimitsu K. A Narrative Review of Compassion Focused Therapy on Positive Mental Health Outcomes. Behav Sci (Basel) 2024; 14:643. [PMID: 39199039 PMCID: PMC11351419 DOI: 10.3390/bs14080643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 07/18/2024] [Accepted: 07/23/2024] [Indexed: 09/01/2024] Open
Abstract
BACKGROUND Compassion-focused therapy (CFT) has been attracting attention in mental health practice and research. CFT is effective in reducing a variety of negative mental health symptoms. Positive mental health (PMH) focuses on an individual's functioning, quality of life, and well-being, aiming to achieve fulfilment. A need for PMH has been increasingly recognised such as national policies incorporating recovery-oriented approaches. However, how effective CFT is for PMH outcomes remains to be investigated. This narrative review aimed to identify the literature that reports evidence on CFT used against PMH outcomes. METHODS Our research questions (RQs) were as follows: RQ1. What PMH outcomes are targeted in CFT intervention research? RQ2. Is CFT effective for PMH?" Medline, Embase, and PsycINFO were searched on the Ovid platform. All studies that mentioned "compassion focused therapy" and "compassion-focused therapy" were searched. RESULTS Sixteen RCTs were included published since 2012. Nine studies were from Europe, four from Asia, two from Northern America, and one from Australia and New Zealand. CFT was used for diverse PMH outcomes, and the effects were overall positive. Self-compassion and compassion were the most frequently evaluated outcomes. CONCLUSIONS The mechanism of action for CFT on PMH needs to be evaluated. CFT can be used as part of personal recovery in mental health. More evidence from non-WEIRD countries including LMICs is needed.
Collapse
Affiliation(s)
- Yasuhiro Kotera
- Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham NG7 2RD, UK (O.T.)
- Center for Infectious Disease Education and Research, Osaka University, Suita 565-0871, Japan
| | - Julie Beaumont
- School of Psychology, Queen’s University Belfast, Belfast BT7 1NN, UK;
| | - Ann-Marie Edwards
- University of Essex Online: Kaplan Open Learning Essex Ltd., Wivenhoe Park, Colchester CO4 3SQ, UK
| | - Matthew Cotterill
- College of Health, Psychology and Social Care, University of Derby, Derby DE22 1GB, UK; (M.C.)
| | - Ann Kirkman
- College of Health, Psychology and Social Care, University of Derby, Derby DE22 1GB, UK; (M.C.)
| | | | - Merly McPhilbin
- Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham NG7 2RD, UK (O.T.)
| | - Simran Takhi
- Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham NG7 2RD, UK (O.T.)
| | | | - Olamide Todowede
- Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham NG7 2RD, UK (O.T.)
| | - Benjamin-Rose Ingall
- Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham NG7 2RD, UK (O.T.)
| | - Kenichi Asano
- Faculty of Human Sciences, University of Tsukuba, Ibaraki 305-8577, Japan
| | - Kohki Arimitsu
- School of Humanities, Kwansei Gakuin University, Hyogo 662-8501, Japan
| |
Collapse
|
8
|
McDonald H, Valmaggia L, Antonova E, Chadwick P. Taking the edge off: a feasibility randomized controlled trial of an online mindfulness-based intervention to reduce suspiciousness/paranoia in high positive schizotypy. Front Psychol 2024; 15:1380077. [PMID: 38962229 PMCID: PMC11221385 DOI: 10.3389/fpsyg.2024.1380077] [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: 02/12/2024] [Accepted: 05/16/2024] [Indexed: 07/05/2024] Open
Abstract
Positive schizotypy can uniquely predict the development of psychosis with suspiciousness/paranoia having emerged as a key risk factor, pointing to significant worth in reducing this aspect in individuals with high positive schizotypy. Reduced paranoia in the general population following brief online mindfulness training has been previously reported. This study investigated the feasibility of a 40-day online mindfulness-based intervention (MBI) (n = 12) in the individuals with high positive schizotypy characterized by high suspiciousness/paranoia and to estimate its effect on paranoia as compared with an active control condition using reflective journaling (n = 12). The outcome measures were self-reported trait and VR-induced state paranoia, completed at baseline, after 10 days and post-intervention. The feasibility criteria included retention, adherence, engagement, and acceptability. There was 100% retention, excellent adherence to content and engagement, with an average MBI session completion rate of 91%. Acceptability, indexed by a self-rated motivation to continue practice post-intervention, was also high. No MBI effect on trait paranoia was observed; however, the MBI group showed a reduction in the VR-induced state paranoia with a medium-to-large effect (d = 0.63). The findings support conducting larger-scale randomized controlled trials to evaluate the effects of online MBIs on reducing suspiciousness/paranoia to mitigate psychosis risk in individuals with high positive schizotypy. Clinical Trial Registration:https://www.isrctn.com/, identifier ISRCTN78697391.
Collapse
Affiliation(s)
- Heather McDonald
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Lucia Valmaggia
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- ORYGEN, Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Department of Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Elena Antonova
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Centre for Cognitive and Clinical Neuroscience, Division of Psychology, Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, United Kingdom
| | - Paul Chadwick
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Department of Psychology, Bath Centre for Mindfulness and Compassion, University of Bath, Bath, United Kingdom
| |
Collapse
|
9
|
Hood AM, Chaman A, Chen Y, Mufti S. Psychological challenges and quality of life in Pakistani parents of children living with thalassemia. J Pediatr Nurs 2024; 76:132-139. [PMID: 38401235 DOI: 10.1016/j.pedn.2024.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 02/16/2024] [Accepted: 02/17/2024] [Indexed: 02/26/2024]
Abstract
PURPOSE Children living with thalassemia experience psychological challenges, but despite significant psychosocial burdens, caregivers' psychological wellbeing and quality of life remain understudied, particularly in lower-and-middle-income countries. DESIGN AND METHOD The current study evaluated these relationships in 100 male and female Pakistani caregivers (23-45 years; 61% female) using Ryff's Psychological Well-Being Scale and the Singapore Caregiver Quality of Life Scale. Caregivers completed questionnaires during regularly scheduled clinic visits for their child. RESULTS We found that Pakistani caregivers in our sample generally had significantly lower (30-40 points) quality of life than a referent sample of caregivers of older adults (ps < 0.001). Self-acceptance and personal growth were consistently significant predictors across quality of life domains. Further, significant interactions were observed. Female caregivers with less self-acceptance had worse mental health and wellbeing and impact on daily life (p < .05). Male caregivers with less personal growth had worse physical health wellbeing (p < .05). CONCLUSIONS Our results demonstrate the importance of considering how distinct aspects of psychological wellbeing, rather than just the overall score, relate to the specific quality of life domains among male and female caregivers. PRACTICE IMPLICATIONS Pediatric nurses are at the frontline of service delivery for children and are in a prime position to observe caregivers who could be at high risk for psychological challenges. Given our findings, future clinical interventions should prioritize support services promoting personal growth and self-acceptance for Pakistani caregivers of children living with thalassemia.
Collapse
Affiliation(s)
- Anna M Hood
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, University of Manchester, Manchester, United Kingdom.
| | - Aqsa Chaman
- Department of Psychology, Government College University, Lahore, Punjab, Pakistan
| | - Yuhui Chen
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, University of Manchester, Manchester, United Kingdom
| | - Sarah Mufti
- Department of Psychology, University of Gujrat, Punjab, Pakistan
| |
Collapse
|
10
|
Pickett SM, Kozak AT, Lanni DJ, Warnke AS, Gaillard P, Jarrett NL. The comparison of brief, online mindfulness and relaxation interventions to reduce stress and improve sleep-related outcomes in college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:1085-1093. [PMID: 35709245 DOI: 10.1080/07448481.2022.2066979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 02/24/2022] [Accepted: 04/10/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The current study aimed to examine whether brief online stress reduction exercises supplemented with sleep improvement strategies would reduce stress, arousal, and sleep difficulties in college students who were not required to use the sleep improvement strategies for participation. PARTICIPANTS A sample of 114 college student participants were enrolled because they were experiencing stress and/or wanted to improve their sleep. METHODS Participants were randomized into an abbreviated progressive muscle relaxation, a mindful breathing, or a self-monitoring control condition for the 4-week intervention. Measures of physical relaxation, mindfulness, perceived stress, pre-sleep arousal, and insomnia symptom severity were collected. RESULTS The APMR group improved on five of the six dependent measures and was significantly different than the SM group at posttest, but not different than the MB group. CONCLUSION The results suggests promise for brief, online, scaled back stress reduction interventions to reduce stress, arousal, and sleep difficulties in college students.
Collapse
Affiliation(s)
- Scott M Pickett
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, Florida, USA
| | - Andrea T Kozak
- Department of Psychology, Oakland University, Rochester, Michigan, USA
| | - Daniel J Lanni
- Department of Psychology, Georgia State University, Atlanta, Georgia, USA
| | - Andrew S Warnke
- Department of Psychology, Oakland University, Rochester, Michigan, USA
| | - Philippe Gaillard
- Office of Clinical Research Advancement, Florida State University, Tallahassee, Florida, USA
| | - Nicole L Jarrett
- Department of Psychology, Oakland University, Rochester, Michigan, USA
| |
Collapse
|
11
|
Atefi GL, van Knippenberg RJM, Bartels SL, Losada-Baltar A, Márquez-González M, Verhey FRJ, de Vugt ME. A Web-Based Intervention Based on Acceptance and Commitment Therapy for Family Caregivers of People With Dementia: Mixed Methods Feasibility Study. JMIR Aging 2024; 7:e53489. [PMID: 38574360 PMCID: PMC11027053 DOI: 10.2196/53489] [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: 10/08/2023] [Revised: 11/24/2023] [Accepted: 01/12/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Acceptance and commitment therapy (ACT), as an empirically based third-wave cognitive behavioral therapy, has shown promise in enhancing well-being and functioning across diverse populations. However, in the context of caregiving, the effect size of available ACT interventions remains at best moderate, sometimes accompanied by high dropout rates, highlighting the need for more effective and feasible intervention designs. OBJECTIVE The objective of our study was to evaluate the feasibility and acceptability of a fully online ACT program designed for family caregivers of people with dementia. This study aimed to boost psychological flexibility and support caregivers, enabling them to realize and prioritize their own life values alongside their caregiving responsibilities. METHODS A mixed methods feasibility study using an uncontrolled pretest-posttest design was conducted. This intervention included a 9-week web-based self-help program based on ACT incorporating collaborative goal setting and weekly web-based motivational coaching for family caregivers of people with dementia. This study involved 30 informal caregivers recruited through memory clinics and social media platforms in the Netherlands and received approval from the Medical Ethics Committee of the Maastricht University Medical Center+ (NL77389.068.21/metc21-029). RESULTS A total of 24 caregivers completed the postintervention assessment, indicating a high adherence rate (24/29, 83%). Caregivers reported positive feedback regarding collaborative goal setting, but some found challenges in implementing new skills due to their own habitual responses or the unpredictable context of dementia caregiving. Personalizing the intervention based on individual value preferences was highlighted as beneficial. CONCLUSIONS Compared to other web-based self-help ACT interventions for family caregivers, this intervention showed a high adherence and sufficient level of feasibility, which underscores the use of personalization in delivering web-based interventions. Moreover, the potential of this ACT-based intervention for family caregivers of people with dementia was demonstrated, suggesting that further research and a larger-scale controlled trial are warranted to validate its effectiveness. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1136/bmjopen-2022-070499.
Collapse
Affiliation(s)
- Golnaz L Atefi
- Department of Psychiatry and Neuropsychology, Alzheimer Centrum Limburg, Maastricht University, Maastricht, Netherlands
| | - Rosalia J M van Knippenberg
- Department of Psychiatry and Neuropsychology, Alzheimer Centrum Limburg, Maastricht University, Maastricht, Netherlands
| | - Sara Laureen Bartels
- Department of Psychiatry and Neuropsychology, Alzheimer Centrum Limburg, Maastricht University, Maastricht, Netherlands
| | - Andrés Losada-Baltar
- Departamento de Psicología, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Madrid, Spain
| | - María Márquez-González
- Biological and Health Psychology Department, School of Psychology, Universidad Autónoma de Madrid, Madrid, Spain
| | - Frans R J Verhey
- Department of Psychiatry and Neuropsychology, Alzheimer Centrum Limburg, Maastricht University, Maastricht, Netherlands
| | - Marjolein E de Vugt
- Department of Psychiatry and Neuropsychology, Alzheimer Centrum Limburg, Maastricht University, Maastricht, Netherlands
| |
Collapse
|
12
|
Ulrich S, Gantenbein AR, Zuber V, Von Wyl A, Kowatsch T, Künzli H. Development and Evaluation of a Smartphone-Based Chatbot Coach to Facilitate a Balanced Lifestyle in Individuals With Headaches (BalanceUP App): Randomized Controlled Trial. J Med Internet Res 2024; 26:e50132. [PMID: 38265863 PMCID: PMC10851123 DOI: 10.2196/50132] [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: 06/27/2023] [Revised: 09/20/2023] [Accepted: 12/12/2023] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Primary headaches, including migraine and tension-type headaches, are widespread and have a social, physical, mental, and economic impact. Among the key components of treatment are behavior interventions such as lifestyle modification. Scalable conversational agents (CAs) have the potential to deliver behavior interventions at a low threshold. To our knowledge, there is no evidence of behavioral interventions delivered by CAs for the treatment of headaches. OBJECTIVE This study has 2 aims. The first aim was to develop and test a smartphone-based coaching intervention (BalanceUP) for people experiencing frequent headaches, delivered by a CA and designed to improve mental well-being using various behavior change techniques. The second aim was to evaluate the effectiveness of BalanceUP by comparing the intervention and waitlist control groups and assess the engagement and acceptance of participants using BalanceUP. METHODS In an unblinded randomized controlled trial, adults with frequent headaches were recruited on the web and in collaboration with experts and allocated to either a CA intervention (BalanceUP) or a control condition. The effects of the treatment on changes in the primary outcome of the study, that is, mental well-being (as measured by the Patient Health Questionnaire Anxiety and Depression Scale), and secondary outcomes (eg, psychosomatic symptoms, stress, headache-related self-efficacy, intention to change behavior, presenteeism and absenteeism, and pain coping) were analyzed using linear mixed models and Cohen d. Primary and secondary outcomes were self-assessed before and after the intervention, and acceptance was assessed after the intervention. Engagement was measured during the intervention using self-reports and usage data. RESULTS A total of 198 participants (mean age 38.7, SD 12.14 y; n=172, 86.9% women) participated in the study (intervention group: n=110; waitlist control group: n=88). After the intervention, the intention-to-treat analysis revealed evidence for improved well-being (treatment: β estimate=-3.28, 95% CI -5.07 to -1.48) with moderate between-group effects (Cohen d=-0.66, 95% CI -0.99 to -0.33) in favor of the intervention group. We also found evidence of reduced somatic symptoms, perceived stress, and absenteeism and presenteeism, as well as improved headache management self-efficacy, application of behavior change techniques, and pain coping skills, with effects ranging from medium to large (Cohen d=0.43-1.05). Overall, 64.8% (118/182) of the participants used coaching as intended by engaging throughout the coaching and completing the outro. CONCLUSIONS BalanceUP was well accepted, and the results suggest that coaching delivered by a CA can be effective in reducing the burden of people who experience headaches by improving their well-being. TRIAL REGISTRATION German Clinical Trials Register DRKS00017422; https://trialsearch.who.int/Trial2.aspx?TrialID=DRKS00017422.
Collapse
Affiliation(s)
- Sandra Ulrich
- School of Applied Psychology, Zurich University of Applied Sciences, Zurich, Switzerland
| | - Andreas R Gantenbein
- Pain and Research Unit, ZURZACH Care, Bad Zurzach, Switzerland
- Department of Neurology, University Hospital Zurich, Zurich, Switzerland
| | - Viktor Zuber
- School of Applied Psychology, Zurich University of Applied Sciences, Zurich, Switzerland
| | - Agnes Von Wyl
- School of Applied Psychology, Zurich University of Applied Sciences, Zurich, Switzerland
| | - Tobias Kowatsch
- Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland
- School of Medicine, University of St.Gallen, St. Gallen, Switzerland
- Centre for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
| | - Hansjörg Künzli
- School of Applied Psychology, Zurich University of Applied Sciences, Zurich, Switzerland
| |
Collapse
|
13
|
Davis CH, Donahue ML, Gaudiano BA, Uebelacker LA, Twohig MP, Levin ME. Adding online storytelling-based acceptance and commitment therapy to antidepressant treatment for primary care patients: a randomized clinical trial. Cogn Behav Ther 2024; 53:48-69. [PMID: 37855277 PMCID: PMC10841889 DOI: 10.1080/16506073.2023.2265560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 09/26/2023] [Indexed: 10/20/2023]
Abstract
Depression is most often treated in primary care, where the prevailing treatment is antidepressant medication. Primary care patients with depression are less likely to be exposed to psychosocial interventions, despite evidence suggesting many of these treatments are effective. An example is acceptance and commitment therapy (ACT), a behavioral treatment for depression with a growing evidence base. A self-guided ACT intervention with a peer narrative (i.e. storytelling) format was developed with the intention of creating a treatment option for primary care patients that was more accessible than traditional psychotherapy. Titled LifeStories, the online program features videos of real individuals sharing coping skills for depression based on lived experiences and key ACT principles. A total of 93 primary care patients taking antidepressants were randomized to either continued antidepressant treatment alone or antidepressant treatment plus LifeStories for 4 weeks. There were no differences over time on depression severity and psychological inflexibility. However, LifeStories led to greater improvements in quality of life and increased patients' interest in additional treatment compared to antidepressant medication alone.Clinical trial pre-registration: ClinicalTrials.gov (NCT04757961).
Collapse
Affiliation(s)
| | | | - Brandon A. Gaudiano
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI
- Butler Hospital, Providence, RI
| | - Lisa A. Uebelacker
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI
- Butler Hospital, Providence, RI
| | | | | |
Collapse
|
14
|
Atefi GL, de Vugt ME, van Knippenberg RJM, Levin ME, Verhey FRJ, Bartels SL. The use of Acceptance and Commitment Therapy (ACT) in informal caregivers of people with dementia and other long-term or chronic conditions: A systematic review and conceptual integration. Clin Psychol Rev 2023; 105:102341. [PMID: 37776577 DOI: 10.1016/j.cpr.2023.102341] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 09/10/2023] [Accepted: 09/22/2023] [Indexed: 10/02/2023]
Abstract
Informal caregivers are the primary source of support for adults with chronic conditions and disabilities. Empirical research highlights chronic stress and other risks of adverse outcomes of caregiving. Acceptance and Commitment Therapy (ACT) is an emerging evidenced-based practice that shows promise in improving an array of outcomes, theoretically by increasing psychological flexibility as the primary process of change. Research has begun to evaluate ACT among informal caregivers of adult populations, and a systematic review is now needed to summarise this evidence base. Electronic searches from five databases, including PubMed, PsycInfo, Embase, CINAHL, and Cochrane Library, yielded an initial 7896 hits, which after screening for inclusion criteria, resulted in 21 clinical trials. Studies were coded to synthesise the feasibility, effectiveness, and quality of evidence. Findings show that ACT was reported to be largely feasible and acceptable. However, the efficacy of ACT was mixed, with a more consistent pattern for informal caregivers of people with dementia. Several methodological quality issues limited the findings. However, theoretical synthesis and preliminary evidence support the promising effect of ACT in subgroups of informal caregivers. Research on the process of change, as well as larger-scale, methodologically rigorous trials, are needed to consolidate these findings.
Collapse
Affiliation(s)
- Golnaz L Atefi
- Department of Psychiatry and Neuropsychology, Alzheimer Centrum Limburg, Maastricht University, Dr. Tanslaan 12, 6229 ET, Maastricht, The Netherlands.
| | - Marjolein E de Vugt
- Department of Psychiatry and Neuropsychology, Alzheimer Centrum Limburg, Maastricht University, Dr. Tanslaan 12, 6229 ET, Maastricht, The Netherlands
| | - Rosalia J M van Knippenberg
- Department of Psychiatry and Neuropsychology, Alzheimer Centrum Limburg, Maastricht University, Dr. Tanslaan 12, 6229 ET, Maastricht, The Netherlands
| | - Michael E Levin
- Department of Psychology, Utah State University, Logan, UT 84322, USA
| | - Frans R J Verhey
- Department of Psychiatry and Neuropsychology, Alzheimer Centrum Limburg, Maastricht University, Dr. Tanslaan 12, 6229 ET, Maastricht, The Netherlands
| | - Sara Laureen Bartels
- Department of Psychiatry and Neuropsychology, Alzheimer Centrum Limburg, Maastricht University, Dr. Tanslaan 12, 6229 ET, Maastricht, The Netherlands; Department of Clinical Neuroscience, Karolinska Institute, Sweden
| |
Collapse
|
15
|
Riva G, Di Lernia D, Tuena C, Bernardelli L, Maldonado JG, Ferrer-Garcia M, Porras-Garcia B, Meyer ML, Shiban Y, Castelnuovo G, Pagnini F, Pedroli E, Sforza F, Clementi A, Sansoni M, Wiederhold BK, Serino S. A Self-Help Virtual Therapeutic Experience Intervention for Overcoming Psychological Distress Related to the COVID-19 Pandemic: Results From the European Multicentric COVID Feel Good Trial. Psychosom Med 2023; 85:639-650. [PMID: 37053096 DOI: 10.1097/psy.0000000000001198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
OBJECTIVE The general objective of the current study was to investigate the efficacy of a novel self-help virtual therapeutic experience (specifically, the COVID Feel Good intervention) in lowering the psychological burden experienced during the COVID-19 lockdowns in four European countries. METHODS We focused on participants recruited from June 2020 to May 2021 in the context of a European multicenter project including four university/academic sites. The total number of participants in the longitudinal studies was 107 (study 1, N = 40; study 2, N = 29; study 3, N = 38). The randomized controlled trial (study 4) included 31 participants in total, 16 in the intervention group and 15 in the control group. Primary outcome measures were depression, anxiety, stress symptoms, perceived stress level, and perceived hopelessness. The secondary outcome was experienced social connectedness. RESULTS Using separate linear mixed-effects models, the most consistent result across countries was a reduction in perceived stress after the participation in the COVID Feel Good intervention. By pooling the results of the models using a random-effects meta-analysis, we found that after the COVID Feel Good intervention, participants reported a decrease in perceived general distress (mean standardized effect size for general distress in the treatment groups compared with the control conditions was -0.52 [ p = .008, 95% confidence interval = -0.89 to -0.14]) and an increase in the perceived social connection (mean standardized effect size for social connection using COVID Feel Good compared with the control conditions was 0.50 [ p ≤ .001, 95% confidence interval = 0.25 to 0.76]). CONCLUSIONS Findings of this study indicate that a virtual self-help intervention is effective in reducing psychological distress. These results contribute to the growing literature supporting the use of digital psychological therapies to relieve psychological distress among the general population during the COVID-19 pandemic.Trial Registration : ISRCTN63887521.
Collapse
Affiliation(s)
- Giuseppe Riva
- From the Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano (Riva, Tuena, Pedroli); Humane Technology Lab, Università Cattolica del Sacro Cuore (Riva, Di Lernia, Pedroli); Become-Hub (Bernardelli, Sforza, Pedroli), Milan, Italy; Department of Clinical Psychology and Psychobiology (Gutiérrez Maldonado, Ferrer-Garcia, Porras-Garcia, Pedroli), University of Barcelona, Barcelona, Spain; Department of Psychology (Meyer, Shiban, Pedroli), Private University of Applied Science, Goettingen, Germany; Clinical Psychology Research Laboratory (Castelnuovo, Pedroli), Ospedale San Giuseppe, IRCCS Istituto Auxologico Italiano, Verbania; Department of Psychology (Castelnuovo, Pagnini, Pedroli, Clementi, Sansoni, Serino), Università Cattolica del Sacro Cuore, Milan, Italy; Faculty of Psychology (Pedroli), University of eCampus, Novedrate, Italy; Virtual Reality Medical Center (Wiederhold), La Jolla, California; Virtual Reality Medical Institute (Wiederhold), Brussels, Belgium
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Liu L, Tian L, Jiang J, Zhang Y, Chi X, Liu W, Zhao YH, Sun P. Effect of an Online Mindfulness-Based Stress Reduction Intervention on Postpandemic Era Nurses' Subjective Well-being, Job Burnout, and Psychological Adaptation. Holist Nurs Pract 2023; 37:244-252. [PMID: 37595116 DOI: 10.1097/hnp.0000000000000603] [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: 08/20/2023]
Abstract
This study explores the effects of an online mindfulness-based stress reduction intervention on postpandemic era nurses' subjective well-being, job burnout, and psychological adaptation. Previous studies on the psychological adaptability of nurses mainly focused on investigation rather than intervention. Ninety nurses were randomly classified into an intervention or control group. The intervention group received weekly online mindfulness-based stress reduction training for 8 weeks. The Subjective Well-being, Job Burnout, and Psychological Use scales were administered pre- and postintervention. Postintervention, nurses' positive emotions and life satisfaction significantly improved. Nurses' psychological adaptation was significantly higher postintervention than preintervention. The total scores for negative emotion, low personal accomplishment, and job burnout were significantly lower postintervention than preintervention. The scores for positive emotion and life satisfaction in the intervention group were significantly higher than those in the control group, and the scores for low personal accomplishment in the intervention group were significantly lower than those in the control group. Online mindfulness-based stress reduction interventions can improve nurses' subjective well-being, reduce job burnout, and improve their level of psychological adaptability. Moreover, it could promote nurses' ability to communicate mindfully with patients and their families. This intervention could help promote the development of mindfulness in the nursing field.
Collapse
Affiliation(s)
- LiHua Liu
- Department of Discipline Construction and Scientific Research Management (Mss Liu, Zhang, Chi, and Sun), Department of Nursing (Mr Tian and Ms Jiang), and Intensive Care Unit (Dr Zhao), The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China; and Department of Nursing, Zhongshan Hospital Affiliated to Dalian University, Dalian, Liaoning, China (Mr Liu)
| | | | | | | | | | | | | | | |
Collapse
|
17
|
Schwartz K, Ganster FM, Tran US. Mindfulness-Based Mobile Apps and Their Impact on Well-Being in Nonclinical Populations: Systematic Review of Randomized Controlled Trials. J Med Internet Res 2023; 25:e44638. [PMID: 37540550 PMCID: PMC10439468 DOI: 10.2196/44638] [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: 11/28/2022] [Revised: 03/16/2023] [Accepted: 06/21/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND Mindfulness-based mobile apps have become popular tools for enhancing well-being in today's fast-paced world. Their ability to reduce geographical, financial, and social barriers makes them a promising alternative to traditional interventions. OBJECTIVE As most available apps lack a theoretical framework, this review aimed to evaluate their effectiveness and assess their quality. We expected to find small sample sizes, high dropout rates, and small effect sizes in the included studies. METHODS A systematic literature search was conducted using PsycInfo, PsycNet, PubMed, an institutional search engine (u:search), and Google Scholar. Randomized controlled trials assessing the impact of mobile mindfulness apps on well-being in nonclinical samples were included. Study selection, risk of bias (using the version 2 of the Cochrane risk-of-bias tool for randomized trials), and reporting quality (using selected CONSORT [Consolidated Standards of Reporting Trials] statement criteria) assessments were performed by 2 authors independently and discussed until a consensus was reached. RESULTS The 28 included randomized controlled trials differed in well-being measures, apps, and intervention duration (7 to 56 days; median duration 28 days). A wide range of sample sizes (12 to 2282; median 161) and attrition rates (0% to 84.7%; median rate 23.4%) were observed. Most studies (19/28, 68%) reported positive effects on at least one aspect of well-being. The effects were presented using different metrics but were primarily small or small to medium in size. Overall risk of bias was mostly high. CONCLUSIONS The wide range of sample sizes, attrition rates, and intervention periods and the variation in well-being measures and mobile apps contributed to the limited comparability of the studies. Although most studies (16/28, 57%) reported small or small to medium effects for at least one well-being outcome, this review demonstrates that the generalizability of the results is limited. Further research is needed to obtain more consistent conclusions regarding the impact of mindfulness-based mobile apps on well-being in nonclinical populations.
Collapse
Affiliation(s)
- Katrin Schwartz
- Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Fabienne Marie Ganster
- Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Ulrich S Tran
- Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| |
Collapse
|
18
|
Kishimoto S, Watanabe N, Yamamoto Y, Imai T, Aida R, Germer C, Tamagawa-Mineoka R, Shimizu R, Hickman S, Nakayama Y, Etoh T, Sahker E, Carnie MB, Furukawa TA. Efficacy of Integrated Online Mindfulness and Self-compassion Training for Adults With Atopic Dermatitis: A Randomized Clinical Trial. JAMA Dermatol 2023; 159:628-636. [PMID: 37163257 PMCID: PMC10173097 DOI: 10.1001/jamadermatol.2023.0975] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 03/10/2023] [Indexed: 05/11/2023]
Abstract
Importance Quality of life (QOL) of patients with atopic dermatitis (AD) is reported to be the lowest among skin diseases. To our knowledge, mindfulness and self-compassion training has not been evaluated for adults with AD. Objective To evaluate the efficacy of mindfulness and self-compassion training in improving the QOL for adults with AD. Design, Setting, and Participants This randomized clinical trial conducted from March 2019 through October 2022 included adults with AD whose Dermatology Life Quality Index (DLQI) score, a skin disease-specific QOL measure, was greater than 6 (corresponding to moderate or greater impairment). Participants were recruited from multiple outpatient institutes in Japan and through the study's social media outlets and website. Interventions Participants were randomized 1:1 to receive eight 90-minute weekly group sessions of online mindfulness and self-compassion training or to a waiting list. Both groups were allowed to receive any dermatologic treatment except dupilumab. Main Outcomes and Measures The primary outcome was the change in the DLQI score from baseline to week 13. Secondary outcomes included eczema severity, itch- and scratching-related visual analog scales, self-compassion and all of its subscales, mindfulness, psychological symptoms, and participants' adherence to dermatologist-advised treatments. Results The study randomized 107 adults to the intervention group (n = 56) or the waiting list (n = 51). The overall participant mean (SD) age was 36.3 (10.5) years, 85 (79.4%) were women, and the mean (SD) AD duration was 26.6 (11.7) years. Among participants from the intervention group, 55 (98.2%) attended 6 or more of the 8 sessions, and 105 of all participants (98.1%) completed the assessment at 13 weeks. The intervention group demonstrated greater improvement in the DLQI score at 13 weeks (between-group difference estimate, -6.34; 95% CI, -8.27 to -4.41; P < .001). The standardized effect size (Cohen d) at 13 weeks was -1.06 (95% CI, -1.39 to -0.74). All secondary outcomes showed greater improvements in the intervention group than in the waiting list group. Conclusions and Relevance In this randomized clinical trial of adults with AD, integrated online mindfulness and self-compassion training in addition to usual care resulted in greater improvement in skin disease-specific QOL and other patient-reported outcomes, including eczema severity. These findings suggest that mindfulness and self-compassion training is an effective treatment option for adults with AD. Trial Registration https://umin.ac.jp/ctr Identifier: UMIN000036277.
Collapse
Affiliation(s)
- Sanae Kishimoto
- Department of Health Promotion and Human Behavior, School of Public Health, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Norio Watanabe
- Department of Psychiatry, Soseikai General Hospital, Kyoto, Japan
| | - Yosuke Yamamoto
- Department of Dermatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Department of Healthcare Epidemiology, School of Public Health, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takumi Imai
- Department of Medical Statistics, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Rei Aida
- Department of Medical Statistics, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Christopher Germer
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
- Center for Mindfulness and Compassion, Cambridge Health Alliance, Cambridge, Massachusetts
| | | | | | - Steven Hickman
- Center for Mindfulness, University of California San Diego
- Global Compassion Coalition, San Rafael, California
| | - Yujiro Nakayama
- Faculty of Medical Sciences, Shonan University of Medical Sciences, Yokohama, Kanagawa, Japan
| | | | - Ethan Sahker
- Department of Health Promotion and Human Behavior, School of Public Health, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Population Health & Policy Research Unit, Medical Education Center, Kyoto University, Kyoto, Japan
| | - Martha B. Carnie
- Center for Patients and Families, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Toshi A. Furukawa
- Department of Health Promotion and Human Behavior, School of Public Health, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| |
Collapse
|
19
|
Garland EL, Gullapalli BT, Prince KC, Hanley AW, Sanyer M, Tuomenoksa M, Rahman T. Zoom-Based Mindfulness-Oriented Recovery Enhancement Plus Just-in-Time Mindfulness Practice Triggered by Wearable Sensors for Opioid Craving and Chronic Pain. Mindfulness (N Y) 2023; 14:1-17. [PMID: 37362184 PMCID: PMC10205566 DOI: 10.1007/s12671-023-02137-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/15/2023] [Indexed: 06/28/2023]
Abstract
Objective The opioid crisis in the USA remains severe during the COVID-19 pandemic, which has reduced access to evidence-based interventions. This Stage 1 randomized controlled trial (RCT) assessed the preliminary efficacy of Zoom-based Mindfulness-Oriented Recovery Enhancement (MORE) plus Just-in-Time Adaptive Intervention (JITAI) prompts to practice mindfulness triggered by wearable sensors (MORE + JITAI). Method Opioid-treated chronic pain patients (n = 63) were randomized to MORE + JITAI or a Zoom-based supportive group (SG) psychotherapy control. Participants completed ecological momentary assessments (EMA) of craving and pain (co-primary outcomes), as well as positive affect, and stress at one random probe per day for 90 days. EMA probes were also triggered when a wearable sensor detected the presence of physiological stress, as indicated by changes in heart rate variability (HRV), at which time participants in MORE + JITAI were prompted by an app to engage in audio-guided mindfulness practice. Results EMA showed significantly greater reductions in craving, pain, and stress, and increased positive affect over time for participants in MORE + JITAI than for participants in SG. JITAI-initiated mindfulness practice was associated with significant improvements in these variables, as well as increases in HRV. Machine learning predicted JITAI-initiated mindfulness practice effectiveness with reasonable sensitivity and specificity. Conclusions In this pilot trial, MORE + JITAI demonstrated preliminary efficacy for reducing opioid craving and pain, two factors implicated in opioid misuse. MORE + JITAI is a promising intervention that warrants investigation in a fully powered RCT. Preregistration This study is registered on ClinicalTrials.gov (NCT04567043).
Collapse
Affiliation(s)
- Eric L. Garland
- University of Utah, 395 South, 1500 East, Salt Lake City, UT 84112 USA
- Salt Lake VA Medical Center, Salt Lake City, USA
| | | | - Kort C. Prince
- University of Utah, 395 South, 1500 East, Salt Lake City, UT 84112 USA
| | - Adam W. Hanley
- University of Utah, 395 South, 1500 East, Salt Lake City, UT 84112 USA
| | | | | | | |
Collapse
|
20
|
Konrad AC, Engert V, Albrecht R, Dobel C, Döring N, Haueisen J, Klimecki O, Sandbothe M, Kanske P. A multicenter feasibility study on implementing a brief mindful breathing exercise into regular university courses. Sci Rep 2023; 13:7908. [PMID: 37193767 DOI: 10.1038/s41598-023-34737-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 05/06/2023] [Indexed: 05/18/2023] Open
Abstract
Practicing mindfulness is associated with stress reduction and with positive effects in the context of learning and teaching. Although effects on student populations have been studied extensively, there are few studies implementing mindfulness exercises in university courses directly. For this reason, we aimed to investigate whether the use of a brief mindfulness exercise in regular university courses, guided by the lecturers, is feasible and has immediate effects on the students' mental states. We conducted a preregistered multicenter study with one observational arm, following an ABAB design. In total, N = 325 students from 19 different university courses were included at baseline and n = 101 students at post measurement. Students were recruited by N = 14 lecturers located in six different universities in Germany. Lecturers started their courses either by guiding a brief mindfulness exercise (intervention condition) or as they regularly would, with no such exercise (control condition). In both conditions, the mental states of students and lecturers were assessed. Over the semester, n = 1193 weekly observations from students and n = 160 observations from lecturers were collected. Intervention effects were analyzed with linear mixed-effects models. The brief mindfulness exercise, compared to no such exercise, was associated with lower stress composite scores, higher presence composite scores, higher motivation for the courses, as well as better mood in students. Effects persisted throughout a respective course session. Lecturers also reported positive effects of instructing mindfulness. Implementing a brief mindfulness exercise in regular university teaching sessions is feasible and has positive effects on both students and lecturers.
Collapse
Affiliation(s)
- Annika C Konrad
- Clinical Psychology and Behavioral Neuroscience, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany.
| | - Veronika Engert
- Institute of Psychosocial Medicine, Psychotherapy, and Psychooncology, Jena University Hospital, Jena, Germany
| | - Reyk Albrecht
- Faculty of Social and Behavioral Sciences, Friedrich Schiller University Jena, Jena, Germany
| | - Christian Dobel
- Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany
| | - Nicola Döring
- Institute of Media and Communication Science, Ilmenau University of Technology, Ilmenau, Germany
| | - Jens Haueisen
- Institute of Biomedical Engineering and Informatics, Ilmenau University of Technology, Ilmenau, Germany
| | - Olga Klimecki
- Clinical Psychology and Behavioral Neuroscience, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
| | - Mike Sandbothe
- Department of Social Work, Ernst Abbe University of Applied Sciences Jena, Jena, Germany
| | - Philipp Kanske
- Clinical Psychology and Behavioral Neuroscience, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
| |
Collapse
|
21
|
Huckvale K, Hoon L, Stech E, Newby JM, Zheng WY, Han J, Vasa R, Gupta S, Barnett S, Senadeera M, Cameron S, Kurniawan S, Agarwal A, Kupper JF, Asbury J, Willie D, Grant A, Cutler H, Parkinson B, Ahumada-Canale A, Beames JR, Logothetis R, Bautista M, Rosenberg J, Shvetcov A, Quinn T, Mackinnon A, Rana S, Tran T, Rosenbaum S, Mouzakis K, Werner-Seidler A, Whitton A, Venkatesh S, Christensen H. Protocol for a bandit-based response adaptive trial to evaluate the effectiveness of brief self-guided digital interventions for reducing psychological distress in university students: the Vibe Up study. BMJ Open 2023; 13:e066249. [PMID: 37116996 PMCID: PMC10151864 DOI: 10.1136/bmjopen-2022-066249] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/30/2023] Open
Abstract
INTRODUCTION Meta-analytical evidence confirms a range of interventions, including mindfulness, physical activity and sleep hygiene, can reduce psychological distress in university students. However, it is unclear which intervention is most effective. Artificial intelligence (AI)-driven adaptive trials may be an efficient method to determine what works best and for whom. The primary purpose of the study is to rank the effectiveness of mindfulness, physical activity, sleep hygiene and an active control on reducing distress, using a multiarm contextual bandit-based AI-adaptive trial method. Furthermore, the study will explore which interventions have the largest effect for students with different levels of baseline distress severity. METHODS AND ANALYSIS The Vibe Up study is a pragmatically oriented, decentralised AI-adaptive group sequential randomised controlled trial comparing the effectiveness of one of three brief, 2-week digital self-guided interventions (mindfulness, physical activity or sleep hygiene) or active control (ecological momentary assessment) in reducing self-reported psychological distress in Australian university students. The adaptive trial methodology involves up to 12 sequential mini-trials that allow for the optimisation of allocation ratios. The primary outcome is change in psychological distress (Depression, Anxiety and Stress Scale, 21-item version, DASS-21 total score) from preintervention to postintervention. Secondary outcomes include change in physical activity, sleep quality and mindfulness from preintervention to postintervention. Planned contrasts will compare the four groups (ie, the three intervention and control) using self-reported psychological distress at prespecified time points for interim analyses. The study aims to determine the best performing intervention, as well as ranking of other interventions. ETHICS AND DISSEMINATION Ethical approval was sought and obtained from the UNSW Sydney Human Research Ethics Committee (HREC A, HC200466). A trial protocol adhering to the requirements of the Guideline for Good Clinical Practice was prepared for and approved by the Sponsor, UNSW Sydney (Protocol number: HC200466_CTP). TRIAL REGISTRATION NUMBER ACTRN12621001223820.
Collapse
Affiliation(s)
- Kit Huckvale
- Centre for Digital Transformation of Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Leonard Hoon
- Applied Artificial Intelligence Institute, Deakin University, Melbourne, Victoria, Australia
| | - Eileen Stech
- Black Dog Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - Jill M Newby
- Black Dog Institute, UNSW Sydney, Sydney, New South Wales, Australia
- School of Psychology, UNSW Sydney, Sydney, New South Wales, Australia
| | - Wu Yi Zheng
- Black Dog Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - Jin Han
- Black Dog Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - Rajesh Vasa
- Applied Artificial Intelligence Institute, Deakin University, Melbourne, Victoria, Australia
| | - Sunil Gupta
- Applied Artificial Intelligence Institute, Deakin University, Melbourne, Victoria, Australia
| | - Scott Barnett
- Applied Artificial Intelligence Institute, Deakin University, Melbourne, Victoria, Australia
| | - Manisha Senadeera
- Applied Artificial Intelligence Institute, Deakin University, Melbourne, Victoria, Australia
| | - Stuart Cameron
- Applied Artificial Intelligence Institute, Deakin University, Melbourne, Victoria, Australia
| | - Stefanus Kurniawan
- Applied Artificial Intelligence Institute, Deakin University, Melbourne, Victoria, Australia
| | - Akash Agarwal
- Applied Artificial Intelligence Institute, Deakin University, Melbourne, Victoria, Australia
| | - Joost Funke Kupper
- Applied Artificial Intelligence Institute, Deakin University, Melbourne, Victoria, Australia
| | - Joshua Asbury
- Applied Artificial Intelligence Institute, Deakin University, Melbourne, Victoria, Australia
| | - David Willie
- Applied Artificial Intelligence Institute, Deakin University, Melbourne, Victoria, Australia
| | - Alasdair Grant
- Applied Artificial Intelligence Institute, Deakin University, Melbourne, Victoria, Australia
| | - Henry Cutler
- Centre for the Health Economy, Macquarie University, Sydney, New South Wales, Australia
| | - Bonny Parkinson
- Centre for the Health Economy, Macquarie University, Sydney, New South Wales, Australia
| | | | - Joanne R Beames
- Black Dog Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - Rena Logothetis
- Applied Artificial Intelligence Institute, Deakin University, Melbourne, Victoria, Australia
| | - Marya Bautista
- Black Dog Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - Jodie Rosenberg
- Black Dog Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - Artur Shvetcov
- Black Dog Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - Thomas Quinn
- Applied Artificial Intelligence Institute, Deakin University, Melbourne, Victoria, Australia
| | - Andrew Mackinnon
- Black Dog Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - Santu Rana
- Applied Artificial Intelligence Institute, Deakin University, Melbourne, Victoria, Australia
| | - Truyen Tran
- Applied Artificial Intelligence Institute, Deakin University, Melbourne, Victoria, Australia
| | - Simon Rosenbaum
- School of Psychiatry, UNSW Sydney, Sydney, New South Wales, Australia
| | - Kon Mouzakis
- Applied Artificial Intelligence Institute, Deakin University, Melbourne, Victoria, Australia
| | | | - Alexis Whitton
- Black Dog Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - Svetha Venkatesh
- Applied Artificial Intelligence Institute, Deakin University, Melbourne, Victoria, Australia
| | - Helen Christensen
- Black Dog Institute, UNSW Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
22
|
Sarfraz A, Siddiqui S, Galante J, Sikander S. Feasibility and Acceptability of an Online Mindfulness-Based Intervention for Stress Reduction and Psychological Wellbeing of University Students in Pakistan: A Pilot Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085512. [PMID: 37107796 PMCID: PMC10139103 DOI: 10.3390/ijerph20085512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/05/2023] [Accepted: 04/12/2023] [Indexed: 05/11/2023]
Abstract
The rise in mental health concerns of university students is causing a serious hinderance to their wellbeing, impeding their functioning. The socio-economic and political friction in low- and middle-income countries adds to their vulnerability and calls for a cost-effective indigenous intervention. Consequently, this study aimed to inform a large definitive trial by assessing the feasibility and acceptability of a randomized controlled trial (RCT) design evaluating a culturally adapted online Mindfulness Training Course (MTC) used to improve stress and wellbeing among Pakistani university students. A two-arm pilot randomized controlled trial was conducted. University students (n = 156) were randomly assigned to either the MTC group (n = 80) or Wait-list (WL) control group (n = 76) and completed baseline and post-intervention self-report measures for mindfulness, stress and psychological wellbeing. Additionally, semi-structured interviews were conducted with consenting MTC group participants (n = 18) to explore their views about MTC, employing reflexive thematic analysis. Of 80 participants randomized to the MTC group, 32 completed the course, whereas, from the 156 randomized participants, 102 completed assessment surveys. Feasibility and acceptability indicators showed high recruitment, compliance, and adherence to MTC, with practical steps for randomization and online data collection. Further results showed higher levels of mindfulness and psychological wellbeing and lowered stress levels in the MTC group compared to the control group. The attrition and dropout rates were high; however, the feedback from participants who completed the MTC was highly positive and encouraging. In conclusion, if the trial proceeds with increased outreach in a large-scale RCT, the recruitment might be revised to reduce attrition rates. Further recommendations are discussed.
Collapse
Affiliation(s)
- Anum Sarfraz
- Department of Behavioral Sciences, School of Social Sciences and Humanities, National University of Sciences and Technology, Islamabad 44000, Pakistan
- Correspondence:
| | - Salma Siddiqui
- Department of Behavioral Sciences, School of Social Sciences and Humanities, National University of Sciences and Technology, Islamabad 44000, Pakistan
| | - Julieta Galante
- Department of Psychiatry, University of Cambridge, Cambridge CB2 0SZ, UK
| | - Siham Sikander
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool L69 3GF, UK
| |
Collapse
|
23
|
Fincham GW, Mavor K, Dritschel B. Effects of Mindfulness Meditation Duration and Type on Well-being: an Online Dose-Ranging Randomized Controlled Trial. Mindfulness (N Y) 2023; 14:1171-1182. [PMID: 37304656 PMCID: PMC10090715 DOI: 10.1007/s12671-023-02119-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/23/2023] [Indexed: 06/13/2023]
Abstract
Objectives This multi-arm randomized controlled online trial explored the effects of two key mindfulness characteristics (dose and type) over 2 weeks on mental well-being, along with psychological distress and dispositional mindfulness, in a healthy community sample. Method Participants were randomly assigned to one of four mindfulness interventions (~ 10 min or ~ 30 min of sitting or movement meditation) to practice daily for 2 weeks; 161 participants fully completed the study and were included in the final sample. We also explored self-reported adherence through how often participants practiced, along with dropout rate via how many participants fully completed the study. Results Well-being and mindfulness scores increased-and distress scores decreased-within all four conditions. However, most importantly, there were no significant differences between the conditions as a function of meditation dose or type. There were also no differences between the conditions on how regularly the meditations were practiced irrespective of type or dose. Additionally, there was no difference on dropout rate regarding meditation dose. However, meditation type had an effect, with a significantly higher dropout rate for participants allocated to a movement meditation irrespective of the dose. Conclusions Brief mindfulness meditation may offer some benefit to well-being regardless of the meditation type and dose but, fundamentally, no differences in effects were detected between short/long sitting meditations and short/long movement meditations. Moreover, the results indicate that movement meditations may possibly be harder to adhere to, potentially informing the tailoring of mindfulness-based self-help programs. Limitations and future directions are also discussed. Preregistration This study was retrospectively registered with the Australian New Zealand Clinical Trials Registry (ACTRN12619000422123). Supplementary Information The online version contains supplementary material available at 10.1007/s12671-023-02119-2.
Collapse
Affiliation(s)
- Guy W. Fincham
- School of Psychology & Neuroscience, University of St Andrews, St Andrews, Scotland
- School of Psychology, University of Sussex, Brighton, England
| | - Ken Mavor
- School of Psychology & Neuroscience, University of St Andrews, St Andrews, Scotland
| | - Barbara Dritschel
- School of Psychology & Neuroscience, University of St Andrews, St Andrews, Scotland
| |
Collapse
|
24
|
Lucas-Thompson RG, Moran MJ. Advancing the Study of Mindfulness-Based Interventions in Relation to Psychological Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085473. [PMID: 37107755 PMCID: PMC10138894 DOI: 10.3390/ijerph20085473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 03/15/2023] [Indexed: 05/11/2023]
Abstract
Since 2006, there has been exponential growth in the number of publications on mindfulness [...].
Collapse
|
25
|
Malighetti C, Bernardelli L, Pancini E, Riva G, Villani D. Promoting Emotional and Psychological Well-Being During COVID-19 Pandemic: A Self-Help Virtual Reality Intervention for University Students. CYBERPSYCHOLOGY, BEHAVIOR AND SOCIAL NETWORKING 2023; 26:309-317. [PMID: 36940285 DOI: 10.1089/cyber.2022.0246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/22/2023]
Abstract
Mental health problems are very common among university students, and the situation worsened during the COVID-19 pandemic. The closure of universities, the restrictions imposed, and the reduction of social activities led to considerable changes in students' lives, thus posing new mental health and emotional challenges. Within this context, promoting university students' general well-being, in particular emotional and psychological well-being, becomes essential. In addition to the possibility of online interventions aimed at overcoming distance limitations and reaching people at their home, other advanced technologies such as virtual reality (VR) have demonstrated the potential to improve people's well-being, quality of life, and positive experiences. The study reported in this article is aimed at exploring the feasibility and preliminary effectiveness of a self-help VR intervention lasting 3 weeks in promoting emotional well-being in university students. Forty-two university students voluntarily participated in a six-session intervention. In each session, a different virtual scenario was presented: two relaxing experiences and four transformative experiences based on metaphors or metaphoric ones aimed at encouraging students to be aware of their emotions and positive resources. Students were randomly allocated to an experimental group and to a waiting list group that started the intervention after 3 weeks. Before and after the six sessions, participants completed an assessment by completing online questionnaires. Results showed a significant increase in both emotional well-being and psychological well-being in the experimental group compared to the waiting list group. The majority of participants said that they would recommend the experience to other students.
Collapse
Affiliation(s)
- Clelia Malighetti
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | | | - Elisa Pancini
- Research Center in Communication Psychology, Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Laboratory, Istituto Auxologico Italiano (IRCCS), Milano, Italy
- Humane Technology Lab, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Daniela Villani
- Research Center in Communication Psychology, Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| |
Collapse
|
26
|
O’Connor M, Stapleton A, O'Reilly G, Murphy E, Connaughton L, Hoctor E, McHugh L. The efficacy of mindfulness-based interventions in promoting resilience: A systematic review and meta-analysis of randomised controlled trials. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2023. [DOI: 10.1016/j.jcbs.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
|
27
|
Sierra MA, Ortiz E. Feasibility and effect of a self-help online acceptance and commitment therapy program focused on repetitive negative thinking for Colombian young women. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2023. [DOI: 10.1016/j.jcbs.2023.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
|
28
|
Kukafka R, Eysenbach G, Wang J, Mao F, Wu L, Huang Y, Sun J, Cao F. Effectiveness of Digital Guided Self-help Mindfulness Training During Pregnancy on Maternal Psychological Distress and Infant Neuropsychological Development: Randomized Controlled Trial. J Med Internet Res 2023; 25:e41298. [PMID: 36763452 PMCID: PMC9960047 DOI: 10.2196/41298] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 12/17/2022] [Accepted: 01/09/2023] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Maternal psychological distress during pregnancy is associated with unfavorable outcomes in infants. Mindfulness-based interventions (MBIs) can effectively alleviate psychological distress, but there are often barriers to the access of face-to-face interventions. OBJECTIVE This study aimed to investigate the effectiveness of a digital guided self-help (GSH) MBI (GSH-MBI) in reducing maternal psychological distress and improving infant neuropsychological performance. METHODS This was a randomized controlled trial. We recruited 160 women who were 12 to 20 weeks pregnant and exhibited psychological distress. We randomized them into a digital GSH-MBI group and a control group (usual perinatal care). The digital GSH-MBI consisted of a 6-week intervention through a WeChat mini program, with a daily reminder sent to the participants by a research assistant via WeChat. The primary outcomes consisted of maternal psychological distress, including depression, anxiety, and pregnancy-related anxiety symptoms, which were assessed at 6 time points from baseline to 6 months post partum (only pregnancy-related anxiety symptoms were assessed 3 times during pregnancy). The secondary outcomes were infant neuropsychological outcomes, including temperament and developmental behaviors, which were assessed at 6 weeks and 6 months post partum. RESULTS Compared with the control group, the digital GSH-MBI group showed a significant reduction in depression, anxiety, and pregnancy-related anxiety symptoms. In addition, the scores of the digital GSH-MBI group were lower than those of the control group for the 3 types of infant temperament at 6 weeks post partum, including quality of mood, distractibility, and adaptability. CONCLUSIONS Digital GSH-MBIs are effective in alleviating psychological distress among pregnant women and protecting infant outcomes. TRIAL REGISTRATION Chinese Clinical Trial Register ChiCTR2000040717; https://www.chictr.org.cn/showproj.aspx?proj=65376.
Collapse
Affiliation(s)
| | | | - Juan Wang
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Fangxiang Mao
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Liuliu Wu
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Yongqi Huang
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Jiwei Sun
- Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Fenglin Cao
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| |
Collapse
|
29
|
Zhang X, Lin P, Sun J, Sun Y, Shao D, Cao D, Cao F. Prenatal stress self-help mindfulness intervention via social media: a randomized controlled trial. J Ment Health 2023; 32:206-215. [PMID: 34264775 DOI: 10.1080/09638237.2021.1952947] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Prenatal stress is a pressing issue. However, there is a lack of robust evidence for psychosocial interventions to manage this problem. AIMS This study aimed to examine the effectiveness of a mindfulness-based intervention on reducing prenatal stress compared to participation in health education groups. METHODS A randomized controlled trial was conducted in a prenatal clinic of comprehensive tertiary care from April to October 2017. A total of 108 pregnant women were randomly assigned to an intervention or a control group. Participants completed self-report measures of depression, anxiety, perceived stress, fatigue, positive and negative affect, and mindfulness before, immediately after, and 15 weeks after the 4-week intervention period. Generalized estimating equations were used to analyze the intervention outcomes. RESULTS The results supported greater improvement in terms of perceived stress (Wald χ2=26.94, p<0.001), fatigue (Wald χ2=17.61, p<0.001), positive affect (Wald χ2=9.03, p = 0.011), negative affect (Wald χ2=11.37, p = 0.003), and mindfulness (Wald χ2=24.97, p<0.001) in the intervention group than in the control group. CONCLUSIONS The self-help mindfulness intervention decreased prenatal stress and negative affect and improved positive affect and mindfulness.
Collapse
Affiliation(s)
- Xuan Zhang
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong Province, China
| | - Pingzhen Lin
- The First Hospital of Quanzhou, Quanzhou, Fujian Province, China
| | - Jiwei Sun
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong Province, China
| | - Yaoyao Sun
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong Province, China
| | - Di Shao
- School of Health Care Management of Shandong University, Jinan, Shandong Province, China
| | - Danfeng Cao
- Shandong Province Qianfoshan Hospital, Jinan, Shandong Province, China
| | - Fenglin Cao
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong Province, China
| |
Collapse
|
30
|
Abbott D, Lack CW, Anderson P. Does Using a Mindfulness App Reduce Anxiety and Worry? A Randomized-Controlled Trial. J Cogn Psychother 2023; 37:26-42. [PMID: 36787997 DOI: 10.1891/jcpsy-d-20-00058] [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: 02/16/2023]
Abstract
Objectives: the availability of smartphone-based mindfulness training applications (apps) may circumvent many barriers to receiving in-person help, but little controlled research has been conducted on them. This study sought to evaluate the effectiveness of a widely used -mindfulness training app, Headspace, at reducing anxiety and worry. Methods: this study used a randomized-controlled design to examine the app using a 3 (Time; baseline, 4 weeks, 8 weeks) × 2 (Access; immediate, delayed for 4 weeks) design. Participants who reported moderate to high anxiety or worry were randomly assigned to receive -either -immediate access or delayed access to the app. For null hypothesis significance testing (NHST), analyses of variance were used to test the hypotheses that app access for 4 and 8 weeks would reduce anxiety and worry as compared to waitlist or baseline and that app access for 8 weeks would reduce anxiety and worry as compared to 4 weeks. Bayes estimates were used to -determine the level of evidence for the hypothesis that app access reduces anxiety and worry. Results: four weeks of app access significantly reduced anxiety symptoms, as did 8 weeks, but NHST indicated there were no significant difference between 4 and 8 weeks of access. We failed to reject the null for the analysis of variance on worry, but Bayesian estimates indicated substantial evidence for the hypothesis that the mindfulness training app reduces worry. Conclusions: this research shows that using Headspace can reduce anxiety and worry, but that there does not appear to be a consistent dose relation.
Collapse
Affiliation(s)
- Deah Abbott
- University of Central Oklahoma, Edmond, Oklahoma, USA
| | - Caleb W Lack
- University of Central Oklahoma, Edmond, Oklahoma, USA
| | - Page Anderson
- Georgia State University, Department of Psychology, Atlanta, Georgia, USA
| |
Collapse
|
31
|
A Faith-Based Intervention to Address Social Isolation and Loneliness in Older Adults. J Christ Nurs 2023; 40:28-35. [PMID: 36469874 DOI: 10.1097/cnj.0000000000001023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
ABSTRACT The goal of this quality improvement project was to determine if virtually offered faith-based resources for socially isolated older adults could reduce loneliness and improve quality of life. A nurse-developed program of virtual spiritual and religious interventions, including mindfulness, prayer, Scripture meditation, gratitude practices, and online church services, was offered by local ministers to older adults at risk of social isolation or loneliness. A sample of 16 adults over age 55 from local communities participated in the 12-week intervention and follow-up. The intervention resulted in a significant decrease in perception of social loneliness and improved physical health quality of life.
Collapse
|
32
|
Lee G, Park SH. How health beliefs and sense of control predict adherence to COVID-19 prevention guidelines among young adults in South Korea. Front Psychol 2022; 13:1025638. [PMID: 36591014 PMCID: PMC9798332 DOI: 10.3389/fpsyg.2022.1025638] [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: 08/23/2022] [Accepted: 11/18/2022] [Indexed: 12/16/2022] Open
Abstract
This study defined adherence to COVID-19 prevention guidelines as health behavior and examined whether the two constructs of the health belief model (i.e., perceived susceptibility and perceived severity) and sense of control predict the level of adherence among young adults in South Korea. An online survey (N = 200) conducted in June 2021, showed that perceived susceptibility, perceived severity, and sense of control positively predict adherence behavior. Sense of control significantly moderated the relationship between perceived susceptibility and adherence even after controlling for depression and perceived health status. Specifically, individuals with a lower level of perceived susceptibility still adhered to COVID-19 prevention guidelines if they had a higher level of sense of control. The finding demonstrates the key role of sense of control in promoting adherence to COVID-19 prevention guidelines and the relationship between sense of control and two constructs of the health belief model. Implication for public messaging targeted at young adults during pandemic situations is also discussed.
Collapse
Affiliation(s)
| | - Soo Hyun Park
- Department of Psychology, Yonsei University, Seoul, South Korea
| |
Collapse
|
33
|
Jones RA, Richards R, Palat R, Hughes C, Hill AJ, Vincent A, Griffin SJ, Ahern AL, Duschinsky R. Participants' experiences of mental health during a COVID-19 tailored ACT-based behavioural weight management intervention: a qualitative study. Int J Qual Stud Health Well-being 2022; 17:2123093. [PMID: 36097888 PMCID: PMC9481081 DOI: 10.1080/17482631.2022.2123093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/06/2022] [Indexed: 10/27/2022] Open
Abstract
PURPOSE We aimed to explore participants' experiences of mental health during an acceptance and commitment therapy (ACT)-based guided self-help intervention to support weight management in adults with overweight or obesity during the COVID-19 pandemic (SWiM-C: Supporting Weight Management during COVID-19). METHODS We conducted semi-structured telephone interviews with twenty participants and used reflexive thematic analysis to identify patterns of meaning across the dataset relevant to mental health. RESULTS Four themes were conceptualized: i) Mental health changes associated with SWiM-C, ii) External factors negatively impacted mental health and intervention engagement, iii) Use and impact of coping responses, and iv) Intervention preferences based on psychological needs. CONCLUSIONS Findings suggest that participants were exposed to multiple factors, both related to and external to the intervention, that negatively impact their mental health, yet ACT-based aspects of the SWiM-C intervention appeared to support participants to adaptively manage the decline in their mental health. The findings can be used to inform the development of future weight management interventions, such as through intervention personalization and the inclusion of more strategies that target emotional regulation.Trial registration: ISRCTN 12107048, https://www.isrctn.com/ISRCTN12107048.
Collapse
Affiliation(s)
| | | | - Roshni Palat
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Carly Hughes
- Fakenham Medical Practice, Norfolk, UK
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Andrew J Hill
- Division of Psychological & Social Medicine, School of Medicine, University of Leeds, Leeds, UK
| | - Ann Vincent
- Department of Medicine, University College London, London, UK
| | - Simon J Griffin
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Amy L. Ahern
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Robbie Duschinsky
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| |
Collapse
|
34
|
Liu C, Chen H, Zhou F, Long Q, Wu K, Lo LM, Hung TH, Liu CY, Chiou WK. Positive intervention effect of mobile health application based on mindfulness and social support theory on postpartum depression symptoms of puerperae. BMC Womens Health 2022; 22:413. [PMID: 36217135 PMCID: PMC9549653 DOI: 10.1186/s12905-022-01996-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 09/26/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE This study investigated the effects of mobile health application designed based on mindfulness and social support theory on parenting self-efficacy and postpartum depression symptoms of puerperae. METHODS We recruited 130 puerperae from a hospital in China and randomized them to an App use group (n = 65) and a waiting control group (n = 65). The App group underwent an 8-week app use intervention while the control group underwent no intervention. We measured four main variables (mindfulness, perceived social support, maternal parental self-efficacy and postpartum depressive symptoms) before and after the App use intervention. RESULTS In the App group, perceived social support, maternal parental self-efficacy were significantly higher and postpartum depressive symptoms was significantly lower. In the control group, there were no significant differences in any of the four variables between the pre-test and post-test. CONCLUSIONS Our findings indicated that the mobile health application may help to improve perceived social support, maternal self-efficacy and reduce postpartum depressive symptoms. The finding of the mobile health application's effect extends our understanding of integrative effects of mindfulness and perceived social support on reduction of postpartum depressive symptoms and suggests clinical potentials in the treatment of postpartum depressive symptoms.
Collapse
Affiliation(s)
- Chao Liu
- grid.495500.d0000 0004 1762 5592School of Journalism and Communication, Hua Qiao University, School of Film and Communication, Xiamen University of Technology, Department of Economic and Management, Suzhou Vocational Institute of Industrial Technology, Xiamen, 361021 China ,grid.145695.a0000 0004 1798 0922Director of Business Analytics Research Center, Chang Gung University, Taoyuan, 33302 Taiwan
| | - Hao Chen
- grid.495500.d0000 0004 1762 5592School of Journalism and Communication, Hua Qiao University, School of Film and Communication, Xiamen University of Technology, Department of Economic and Management, Suzhou Vocational Institute of Industrial Technology, Xiamen, 361021 China ,grid.145695.a0000 0004 1798 0922Director of Business Analytics Research Center, Chang Gung University, Taoyuan, 33302 Taiwan
| | - Fang Zhou
- grid.495500.d0000 0004 1762 5592School of Journalism and Communication, Hua Qiao University, School of Film and Communication, Xiamen University of Technology, Department of Economic and Management, Suzhou Vocational Institute of Industrial Technology, Xiamen, 361021 China
| | - Qiqi Long
- grid.8547.e0000 0001 0125 2443Shanghai Obstetrics and Gynecology Hospital, Fudan University, Shanghai, 200090 China
| | - Kan Wu
- grid.145695.a0000 0004 1798 0922Director of Business Analytics Research Center, Chang Gung University, Taoyuan, 33302 Taiwan ,grid.413801.f0000 0001 0711 0593Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Taoyuan, 33302 Taiwan
| | - Liang-Ming Lo
- grid.145695.a0000 0004 1798 0922Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taipei, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Tai-Ho Hung
- grid.145695.a0000 0004 1798 0922Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taipei, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Chia-Yih Liu
- grid.413801.f0000 0001 0711 0593Department of Psychiatry, Chang Gung Memorial Hospital, Taipei, 10507 Taiwan
| | - Wen-Ko Chiou
- grid.413801.f0000 0001 0711 0593Department of Psychiatry, Chang Gung Memorial Hospital, Taipei, 10507 Taiwan ,grid.145695.a0000 0004 1798 0922Department of Industrial Design, Chang Gung University, Taoyuan, 33302 Taiwan ,grid.440372.60000 0004 1798 0973Department of Industrial Engineering and Management, Ming Chi University of Technology, New Taipei, 24301 Taiwan
| |
Collapse
|
35
|
Cheung RYM, Chan SKC, Chui H, Chan WM, Ngai SYS. Enhancing Parental Well-being: Initial Efficacy of a 21-Day Online Self-help Mindfulness-Based Intervention for Parents. Mindfulness (N Y) 2022; 13:2812-2826. [PMID: 36248240 PMCID: PMC9540077 DOI: 10.1007/s12671-022-01998-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/20/2022] [Indexed: 11/30/2022]
Abstract
Objectives Parental self-care is extremely important in the face of stress throughout parenthood. A 21-day online mindfulness-based intervention was developed that was aimed at enhancing parental well-being. The present study evaluated this intervention by examining its initial efficacy on parents' mindfulness, parenting stress, subjective well-being, and symptoms of depression and anxiety. Methods Participants were 273 parents (90.11% mothers) who were randomly assigned to the 21-day mindfulness-based intervention group (n = 136) or waitlist control group (n = 137). Pre-intervention assessment, immediate post-intervention assessment, and 30-day follow-up assessment were conducted to assess parents' mindfulness, parenting stress, subjective well-being, and symptoms of depression and anxiety. Results Linear mixed models indicated that the group × time effects on subjective well-being, anxiety symptoms, and mindfulness were significant, after controlling for sex, age, education, income, habit of mindfulness practice, hours of weekly mindfulness practice, and diagnostic history of psychiatric disorder. Follow-up analyses indicated that compared to baseline, participants from the intervention group reported significantly greater subjective well-being and mindfulness, and fewer symptoms of anxiety than did those from the waitlist control group. The group × time effects on parenting stress and depressive symptoms were non-significant. Exploratory findings further suggested practicality and perceived acceptability of the intervention. Conclusions This study showed initial efficacy of a 21-day online mindfulness-based intervention on parents' subjective well-being, anxiety symptoms, and mindfulness. The findings inform researchers and practitioners about the utility of a brief mindfulness-based intervention in promotion parental well-being. Other areas of feasibility warrant future investigation.
Collapse
Affiliation(s)
- Rebecca Y. M. Cheung
- School of Psychology and Clinical Language Sciences, Harry Pitt Building, University of Reading, Earley Gate, Reading, RG6 6ES UK
- Department of Early Childhood Education, The Education University of Hong Kong, Hong Kong, Hong Kong
| | | | - Harold Chui
- Department of Educational Psychology, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Wing Man Chan
- New Life Psychiatric Rehabilitation Association, Hong Kong, Hong Kong
| | - Sammy Y. S. Ngai
- New Life Psychiatric Rehabilitation Association, Hong Kong, Hong Kong
| |
Collapse
|
36
|
Sierra MA, Ruiz FJ. Content validity and perceived utility of a self-help online acceptance and commitment therapy program focused on repetitive negative thinking. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2022; 26:1-10. [PMID: 35990417 PMCID: PMC9381937 DOI: 10.1016/j.jcbs.2022.08.003] [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] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 08/08/2022] [Accepted: 08/09/2022] [Indexed: 11/23/2022]
Abstract
Telehealth strategies have become essential for responding to the sanitary emergency due to the COVID-19 pandemic. In this context, developing online psychological interventions (OPIs) that can treat and prevent psychological difficulties is gaining more relevance. This article describes an acceptance and commitment therapy (ACT) based OPI focused on repetitive negative thinking (RNT). This OPI is called Disentangled, Aware, and Committed (DAC) and represents an attempt to adapt previous RNT-focused ACT protocols to this format type. Study 1 evaluated content validity through the assessment of four experts in ACT regarding clarity, utility, pertinence, conceptual adjustment, and therapeutic goal fulfillment for each component of the DAC program. In Study 2, forty-one undergraduate clinical psychology trainees rated the components of the DAC program according to its clarity and perceived utility. These participants were enrolled in a randomized controlled trial that analyzed the efficacy of the DAC to prevent the usually observed increase in emotional symptoms and RNT among this population. Expert reviewers in Study 1 rated all DAC components as clear and useful for potential users, following a logical order, theoretically coherent with the ACT model, and successfully fulfilling its stated goals. In Study 2, the participants also rated the DAC components as clear and potentially useful for their lives. In conclusion, the DAC appears to be a feasible transdiagnostic OPI for treating and preventing emotional symptoms, which warrants further studies analyzing its efficacy.
Collapse
Affiliation(s)
- Marge A Sierra
- Fundación Universitaria Konrad Lorenz, Carrera 9 Bis, Nº 62-43, Bogotá, Colombia
| | - Francisco J Ruiz
- Fundación Universitaria Konrad Lorenz, Carrera 9 Bis, Nº 62-43, Bogotá, Colombia
| |
Collapse
|
37
|
Tzioridou S, Dresler M, Sandberg K, Mueller EM. The role of mindful acceptance and lucid dreaming in nightmare frequency and distress. Sci Rep 2022; 12:15737. [PMID: 36131106 PMCID: PMC9492730 DOI: 10.1038/s41598-022-19624-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 08/31/2022] [Indexed: 11/15/2022] Open
Abstract
A theoretical and empirical association between lucid dreaming and mindfulness, as well as lucid dreaming and nightmares has previously been observed; however, the relationship between nightmares and mindfulness has received surprisingly little attention. Here, we present the findings of two studies exploring the relation of nightmare frequency and distress with two components of mindfulness, termed presence and acceptance, as well as lucid dreaming. Study 1 (N = 338) consisted of a low percentage of frequent lucid dreamers whereas Study 2 (N = 187) consisted primarily of frequent lucid dreamers that used lucid dream induction training techniques and meditation. Across studies, nightmare-related variables showed a more robust association with mindful acceptance as opposed to mindful presence. Moreover, individuals with high levels of meditation expertise and practice of lucid dreaming induction techniques reported lower nightmare frequency. Finally, in Study 2, which consisted of frequent lucid dreamers, a positive correlation between lucid dreaming frequency and mindfulness was apparent. The present findings support the notion that wakeful mindfulness is associated with the quality of dreams and extend previous research by suggesting a disentangled role of the two facets of mindfulness in dream variation. This association remains open for experimental manipulation, the result of which could have clinical implications.
Collapse
Affiliation(s)
- Sofia Tzioridou
- Department of Psychology, Philipps University Marburg, Marburg, Germany. .,Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands.
| | - Martin Dresler
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Kristian Sandberg
- Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark
| | - Erik M Mueller
- Department of Psychology, Philipps University Marburg, Marburg, Germany
| |
Collapse
|
38
|
Williams K, Hartley S, Langer S, Manandhar‐Richardson M, Sinha M, Taylor P. A systematic review and meta-ethnographic synthesis of Mindfulness-based Cognitive Therapy for people with major depression. Clin Psychol Psychother 2022; 29:1494-1514. [PMID: 35912665 PMCID: PMC9805101 DOI: 10.1002/cpp.2773] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 07/18/2022] [Accepted: 07/20/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND Mindfulness-based Cognitive Therapy (MBCT) is a relapse-prevention intervention for people experiencing major depression. Three qualitative meta-syntheses investigating experiences of taking part in MBCT and/or Mindfulness-based Stress Reduction (MBSR) across different diagnostic populations reported themes including control, choice, group processes, relationships and struggles. As multiple studies have been published since, we aimed to update, systematically review and synthesize the experiences of participants with depression taking part in MBCT. METHODS Four databases were searched systematically (PsycInfo, Web of Science, Medline and CINAHL) up to and including 12 November 2021. Twenty-one qualitative studies met the review criteria. All papers were rated as fair using a quality appraisal tool. Meta-ethnography was applied. RESULTS Across 21 studies of participants with current or previous depression who had participated in MBCT, three overarching themes were developed: 'Becoming skilled and taking action', 'Acceptance' and 'Ambivalence and Variability'. Participants became skilled through engagement in mindfulness practices, reporting increased awareness, perspective and agency over their experiences. Participants developed acceptance towards their experiences, self and others. There was variability and ambivalence regarding participants' expectations and difficulties within mindfulness practices. LIMITATIONS Many studies were conducted in MBCT-research centres that may hold conflicts of interest. Many studies did not address the impact of the participant-researcher relationship thus potentially affecting their interpretations. Studies were skewed towards the experiences of female participants. CONCLUSIONS Our findings help to enhance participant confidence in MBCT, alongside understanding the processes of change and the potential for difficulties. MBCT is beneficial and provides meaningful change for many but remains challenging for some.
Collapse
Affiliation(s)
- Kate Williams
- Division of Psychology & Mental Health, School of Health SciencesUniversity of Manchester, Manchester Academic Health Sciences CentreManchesterUK
- Greater Manchester Mental Health NHS Foundation TrustManchesterUK
- Department of Psychology, Faculty of Health, Psychology, and Social CareManchester Metropolitan UniversityManchesterUK
| | - Samantha Hartley
- Division of Psychology & Mental Health, School of Health SciencesUniversity of Manchester, Manchester Academic Health Sciences CentreManchesterUK
- Pennine Care NHS Foundation TrustAshton‐under‐LyneUK
| | - Susanne Langer
- Department of Psychology, Faculty of Health, Psychology, and Social CareManchester Metropolitan UniversityManchesterUK
| | | | - Melissa Sinha
- Division of Psychology & Mental Health, School of Health SciencesUniversity of Manchester, Manchester Academic Health Sciences CentreManchesterUK
- Greater Manchester Mental Health NHS Foundation TrustManchesterUK
| | - Peter Taylor
- Division of Psychology & Mental Health, School of Health SciencesUniversity of Manchester, Manchester Academic Health Sciences CentreManchesterUK
| |
Collapse
|
39
|
Taylor H, Cavanagh K, Field AP, Strauss C. Health Care Workers' Need for Headspace: Findings From a Multisite Definitive Randomized Controlled Trial of an Unguided Digital Mindfulness-Based Self-help App to Reduce Healthcare Worker Stress. JMIR Mhealth Uhealth 2022; 10:e31744. [PMID: 36006668 PMCID: PMC9459942 DOI: 10.2196/31744] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 02/27/2022] [Accepted: 06/08/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Health care workers experience high stress. Accessible, affordable, and effective approaches to reducing stress are lacking. In-person mindfulness-based interventions can reduce health care worker stress but are not widely available or accessible to busy health care workers. Unguided, digital, mindfulness-based self-help (MBSH) interventions show promise and can be flexibly engaged with. However, their effectiveness in reducing health care worker stress has not yet been explored in a definitive trial. OBJECTIVE This study aimed to investigate the effectiveness of an unguided digital MBSH app (Headspace) in reducing health care worker stress. METHODS This was a definitive superiority randomized controlled trial with 2182 National Health Service staff in England recruited on the web and allocated in a 1:1 ratio to fully automated Headspace (n=1095, 50.18%) or active control (Moodzone; n=1087, 49.82%) for 4.5 months. Outcomes were subscales of the Depression, Anxiety, and Stress (primary outcome) Scale short form; Short Warwick Edinburgh Mental Well-being Scale; Maslach Burnout Inventory; 15-item Five-Facet Mindfulness Questionnaire minus Observe items; Self-Compassion Scale-Short Form; Compassionate Love Scale; Penn State Worry Questionnaire; Brooding subscale of the Ruminative Response Scale; and sickness absence. RESULTS Intention-to-treat analyses found that Headspace led to greater reductions in stress over time than Moodzone (b=-0.31, 95% CI -0.47 to -0.14; P<.001), with small effects. Small effects of Headspace versus Moodzone were found for depression (b=-0.24, 95% CI -0.40 to -0.08; P=.003), anxiety (b=-0.19, 95% CI -0.32 to -0.06; P=.004), well-being (b=0.14, 95% CI 0.05-0.23; P=.002), mindfulness (b=0.22, 95% CI 0.09-0.34; P=.001), self-compassion (b=0.48, 95% CI 0.33-0.64; P<.001), compassion for others (b=0.02, 95% CI 0.00-0.04; P=.04), and worry (b=-0.30, 95% CI -0.51 to -0.09; P=.005) but not for burnout (b=-0.19, -0.04, and 0.13, all 95% CIs >0; P=.65, .67, and .35), ruminative brooding (b=-0.06, 95% CI -0.12 to 0.00; P=.06), or sickness absence (γ=0.09, 95% CI -0.18 to 0.34). Per-protocol effects of Headspace (454/1095, 41.46%) versus Moodzone (283/1087, 26.03%) over time were found for stress, self-compassion, and compassion for others but not for the other outcomes. Engagement (practice days per week) and improvements in self-compassion during the initial 1.5-month intervention period mediated pre- to postintervention improvements in stress. Improvements in mindfulness, rumination, and worry did not mediate pre- to postintervention improvements in stress. No serious adverse events were reported. CONCLUSIONS An unguided digital MBSH intervention (Headspace) can reduce health care workers' stress. Effect sizes were small but could have population-level benefits. Unguided digital MBSH interventions can be part of the solution to reducing health care worker stress alongside potentially costlier but potentially more effective in-person mindfulness-based interventions, nonmindfulness courses, and organizational-level interventions. TRIAL REGISTRATION International Standard Randomised Controlled Trial Number ISRCTN15424185; https://tinyurl.com/rv9en5kc.
Collapse
Affiliation(s)
- Heather Taylor
- School of Psychology, University of Sussex, Brighton, United Kingdom
| | - Kate Cavanagh
- School of Psychology, University of Sussex, Brighton, United Kingdom
| | - Andy P Field
- School of Psychology, University of Sussex, Brighton, United Kingdom
| | - Clara Strauss
- School of Psychology, University of Sussex, Brighton, United Kingdom
- Sussex Partnership NHS Foundation Trust, Hove, United Kingdom
| |
Collapse
|
40
|
Ju R, Chiu W, Zang Y, Hofmann SG, Liu X. Effectiveness and mechanism of a 4-week online self-help mindfulness intervention among individuals with emotional distress during COVID-19 in China. BMC Psychol 2022; 10:149. [PMID: 35698165 PMCID: PMC9190451 DOI: 10.1186/s40359-022-00831-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 05/05/2022] [Indexed: 11/10/2022] Open
Abstract
Background Many people suffered from emotional distress especially during the COVID-19 pandemic. In order to alleviate emotional distress, more accessible psychological intervention programs, such as online intervention programs, are needed. The study aimed to investigate the efficacy and the potential mechanism of a 4-week, online, self-help mindfulness-based intervention to manage emotional distress during the COVID-19 pandemic between February 3 and May 20, 2020. Methods A total of 302 individuals with high emotional distress completed a self-help mindfulness course, which lasted 30–60 min per day for 28 consecutive days. Participants who registered in the program later were included in the analyses as the control group (n = 315). Levels of mindfulness, perceived stress, emotional distress, anxiety and depression were assessed at baseline(T1), week 1(T2), week 2(T3), week 3(T4) and week 4(T5). Results Significant Group by Time interaction effects were found on mindfulness, perceived stress, emotional distress, anxiety and depression (p < 0.001). Compared to the control group, the intervention group had a greater increase in changes of all outcome variables (p < 0.001). Random intercept cross-lagged analyses showed that compared with control group, mindfulness at T2 and T4 negatively predicted stress at T3 and T5, and mindfulness at T2 and T4 negatively predicted depression at T3 and T5 while depression at T3 predicted mindfulness at T4 in the mindfulness group. Conclusions The results suggest that a 4-week self-help online mindfulness intervention improved mindfulness and reduced stress, emotional distress, anxiety and depression symptoms. Compared to the control group, changes in mindfulness preceded changes in stress, and mindfulness and depression reciprocally influenced each other during the intervention. Trial registration Chinese Clinical Trial Registry: ChiCTR2000034539. Registered 9 July 2020—Retrospectively registered, http://www.chictr.org.cn/edit.aspx?pid=55721&htm=4. Supplementary Information The online version contains supplementary material available at 10.1186/s40359-022-00831-7.
Collapse
Affiliation(s)
- Ruilin Ju
- Beijing Key Laboratory of Behavior and Mental Health, School of Psychological and Cognitive Sciences, Peking University, No. 5 Yiheyuan Road Haidian District, Beijing, People's Republic of China
| | - Wingsze Chiu
- Beijing Key Laboratory of Behavior and Mental Health, School of Psychological and Cognitive Sciences, Peking University, No. 5 Yiheyuan Road Haidian District, Beijing, People's Republic of China
| | - Yinyin Zang
- Beijing Key Laboratory of Behavior and Mental Health, School of Psychological and Cognitive Sciences, Peking University, No. 5 Yiheyuan Road Haidian District, Beijing, People's Republic of China
| | - Stefan G Hofmann
- Department of Clinical Psychology, Philipps-University Marburg, Marburg, Germany.,Department of Psychological and Brain Sciences, Boston University, 900 Commonwealth Avenue, 2nd Floor, Boston, MA, 02215, USA
| | - Xinghua Liu
- Beijing Key Laboratory of Behavior and Mental Health, School of Psychological and Cognitive Sciences, Peking University, No. 5 Yiheyuan Road Haidian District, Beijing, People's Republic of China.
| |
Collapse
|
41
|
Webb JB, Padro MP, Thomas EV, Davies AE, Etzel L, Rogers CB, Heredia NI. Yoga at Every Size: A Preliminary Evaluation of a Brief Online Size-Inclusive Yoga and Body Gratitude Journaling Intervention to Enhance Positive Embodiment in Higher Weight College Women. Front Glob Womens Health 2022; 3:852854. [PMID: 35720811 PMCID: PMC9199427 DOI: 10.3389/fgwh.2022.852854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 04/11/2022] [Indexed: 11/19/2022] Open
Abstract
The present pilot randomized controlled trial (RCT) evaluated the feasibility, acceptability, and preliminary efficacy of a 4-week online yoga and body gratitude journaling intervention for strengthening positive embodiment among racially-diverse higher weight college women. Seventy-five participants were initially randomized to either the yoga condition (n = 36) or to a wait-list control (n = 39). Participants completed measures of positive and negative body image, weight bias internalization, self-compassion, drive for leanness, and physical activity acceptance at both baseline and post. Preliminary results among the 42 analyzed completers (mean age = 20.9, SD = 2.4; 30% Black or African American) revealed acceptable feasibility given the low-intensity nature of the intervention reflected in a 36% attrition rate. Self-reported adherence was strong for the yoga component with 81% of participants indicating that they practiced with the videos ≥3–4 times per week as suggested. Although 71% reported completing the body gratitude journal ≥1–2 times per week, daily adherence was minimal. Acceptability was also high among participants randomized to the yoga condition as indicated by 86% expressing at least moderate levels of satisfaction with the overall program. Qualitative feedback from participants further supported the acceptability of the program and pointed to important areas in further refining the protocol in the future. Preliminary efficacy was supported by significant reductions in internal body shame and gains in body appreciation, functional body appreciation, functional body satisfaction, functional body awareness, and behavioral commitment to physical activity engagement among the yoga vs. wait-list control participants. These promising findings once replicated in larger, higher-powered trials may have important implications for extending the reach and accessibility of mind-body wellness practices like yoga to benefit racially-/ethnically-diverse college women of higher weight. This research is further responsive to the growing need for efficacious remotely-delivered, and scalable behavioral health interventions in the ongoing era of the COVID-19 pandemic. However, additional research is warranted to explore ways of enhancing engagement of participants with lower levels of positive embodiment and to further incentivize the journaling component of the intervention.
Collapse
Affiliation(s)
- Jennifer B. Webb
- Department of Psychology, University of North Carolina at Charlotte, Charlotte, NC, United States
- *Correspondence: Jennifer B. Webb
| | - Meagan P. Padro
- Department of Education, UNC Chapel Hill, Chapel Hill, NC, United States
| | - Erin Vinoski Thomas
- Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, United States
| | - Alexandria E. Davies
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, United States
| | - Lena Etzel
- Department of Psychology, University of North Carolina at Charlotte, Charlotte, NC, United States
| | | | - Natalia I. Heredia
- Department of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, United States
| |
Collapse
|
42
|
Chung J, Mundy ME, McKenzie S. A Self-Managed Online Mindfulness Program in a University-Wide Learning Management System Orientation Site: A Real-World Ecological Validation Study. Front Psychol 2022; 13:869765. [PMID: 35602693 PMCID: PMC9121920 DOI: 10.3389/fpsyg.2022.869765] [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: 02/05/2022] [Accepted: 03/28/2022] [Indexed: 11/15/2022] Open
Abstract
The efficacy of mindfulness-based interventions in randomised-controlled trials and large experimental studies has been demonstrated in university student populations. Whilst these investigations have provided insight into the nature of the delivery of mindfulness-based practices, there has been little research in the implementation of self-managed online student wellbeing and mindfulness programs at university. This ecological validation study conducted in 2020 evaluated a real-world implementation of a large, university-wide, online mindfulness-based program that was accessible fully online via the tertiary institutions’ Learning Management System (LMS) student orientation site. The total sample included 833 participants from a range of disciplines and faculties at Monash University, Australia. At the end of the study, 236 (28.3%) participants were retained and completed the follow-up survey. Participants had the option to engage with the fully self-managed online mindfulness program for a 12-week semester. The mindfulness practices were pre-recorded, audio-guided sessions, and 10–15 min in length. Baseline and end of semester questionnaires included the 14-item Warwick-Edinburgh Mental Wellbeing Scale, 10-item Perceived Stress Scale and the 18-item Five Facet Mindfulness Questionnaire. Participants who engaged with the mindfulness program over 3 or more weeks showed significant improvements in all three outcome measures, and all participants showed significant improvements in wellbeing at the end of semester. Learning analytics obtained via the LMS revealed that 58.6% (n = 489) had not logged into the mindfulness program at all, almost a third (31.0%, n = 259) logged into the program materials once or twice, and 10.2% (n = 85) of the whole sample engaged with the program actively, having logged in three or more times. The total number of student logins peaked in week 2, reduced between week 2 and week 7 and thereafter activity remained stable until the end of the semester. We hypothesise that the changes in wellbeing, stress and mindfulness at the end of the semester seen in the low engagement participants may partly be explained by the circumstances of COVID-19 restrictions improving. This study has revealed and discusses the complexities of student behaviour and implications for implementing an online mindfulness program in the real- world setting of a university.
Collapse
Affiliation(s)
- Jennifer Chung
- School of Psychological Sciences, Monash University, Melbourne, VIC, Australia
| | - Matthew E Mundy
- Monash Centre for Professional Development and Monash Online Education, Monash University, Melbourne, VIC, Australia
| | - Stephen McKenzie
- School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
| |
Collapse
|
43
|
Trygg Lycke S, Airosa F, Lundh L. Emergency Department Nurses' Experiences of a Mindfulness Training Intervention: A Phenomenological Exploration. J Holist Nurs 2022; 41:170-184. [PMID: 35574608 DOI: 10.1177/08980101221100091] [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: 11/15/2022]
Abstract
Purpose: The purpose of this study was to explore emergency care nurses' experiences of an intervention to increase compassion and empathy and reduce stress through individual mindfulness training delivered via workshops and a smartphone application. We also explored how the nurses felt about the practical and technical aspects of the intervention. Design: Qualitative interview study. Method: Individual interviews were conducted with eight of the 56 participants in the intervention study and used phenomenological analysis to illuminate how they made sense of their lived experiences of mindfulness training. Findings: Three themes illuminated the nurses' experiences: becoming aware, changing through mindfulness, and gaining the tools for mindfulness through workshops and the mobile application. The first two themes expressed personal experiences, whereas the third expressed experiences of the practical and technical aspects of the intervention. Most nurses found the mobile application easy to use and effective. Conclusions: Emergency care nurses can feel that the awareness and changes that come with mindfulness training benefit them, their colleagues, and the patients for whom they care. The findings also provide insights into the challenges of practicing mindfulness in a busy emergency care setting and into the practical aspects of using a smartphone application to train mindfulness.
Collapse
Affiliation(s)
- Sofia Trygg Lycke
- Specialist nurse and health care development leader, Academic Primary Health Care Centre, Region Stockholm, Sweden
| | - Fanny Airosa
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, 27106Karolinska Institutet, Stockholm, Sweden.,Quality developer, 83223Ersta Hospital, Stockholm, Sweden
| | - Lena Lundh
- Specialist nurse and head of the Lifestyle Unit, Academic Primary Health Care Centre, Region Stockholm, Sweden.,Researcher, Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, 27106Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
44
|
Forbes L, Johnson SK. Online Mindfulness Intervention for Inflammatory Bowel Disease: Adherence and Efficacy. Front Psychol 2022; 12:709899. [PMID: 35401288 PMCID: PMC8987583 DOI: 10.3389/fpsyg.2021.709899] [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] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 12/30/2021] [Indexed: 12/30/2022] Open
Abstract
The impact of stress and other psychological variables on Inflammatory Bowel Disease (IBD) prognosis, treatment response, and functional level is well-established; however, typical IBD treatment focuses on the physiological pathology of the disease and neglects complementary stress-reducing interventions. Recent pilot studies report the benefits of mindfulness-based interventions (MBIs) in people living with IBD, but are limited by small sample sizes. Recruitment challenges to in-person studies may be in part due to the difficulty IBD patients often have adhering to fixed schedules and travel as a result of IBD symptoms such as pain, fatigue, and incontinence. The current study aimed to address this barrier by offering participants access to online mindfulness training, allowing individuals to engage with intervention materials to fit their own schedule. Online mindfulness programs have gained popularity in recent years, as they increase access and flexibility and decrease cost to the user; however, the dropout rate tends to be high. The current study compared the rate of adherence and efficacy of mindfulness training as a function of level of support: self-guided versus supported. Analysis revealed no significant difference in the benefits received between participants in the two groups; however, a significant difference group (χ2 = 15.75; p = 0.000, r = 0.38) was found in terms of rate of completion, with 44.1% of the supportive group completing the protocol compared to 11.7% of the self-guided. Common challenges to meditation were measured, but did not significantly predict adherence to the intervention, and experience of these challenges did not significantly change (increase or decrease) over the duration of the study. Implications of the current research, future directions for the use of MBI for IBD patients, and a discussion of methodological considerations are provided.
Collapse
Affiliation(s)
- Leila Forbes
- BASE Cognitive Behavioral, Charlotte, NC, United States
| | - Susan K. Johnson
- Department of Psychological Science, University of North Carolina at Charlotte, Charlotte, NC, United States
| |
Collapse
|
45
|
Li I, Chen AZ, Newby JM, Kladnitski N, Haskelberg H, Millard M, Mahoney A. The uptake and outcomes of an online self-help mindfulness programme during COVID-19. CLIN PSYCHOL-UK 2022. [DOI: 10.1080/13284207.2022.2045866] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Ian Li
- Clinical Research Unit for Anxiety and Depression, St Vincent’s Hospital, Darlinghurst, Sydney, New South Wales, Australia
| | - Aileen Z. Chen
- Clinical Research Unit for Anxiety and Depression, St Vincent’s Hospital, Darlinghurst, Sydney, New South Wales, Australia
| | - Jill M. Newby
- School of Psychology, Faculty of Science, University of New South Wales, Sydney, NSW, Australia
- Black Dog Institute, Randwick, NSW, Australia
| | - Natalie Kladnitski
- Clinical Research Unit for Anxiety and Depression, St Vincent’s Hospital, Darlinghurst, Sydney, New South Wales, Australia
| | - Hila Haskelberg
- Clinical Research Unit for Anxiety and Depression, St Vincent’s Hospital, Darlinghurst, Sydney, New South Wales, Australia
| | - Michael Millard
- Clinical Research Unit for Anxiety and Depression, St Vincent’s Hospital, Darlinghurst, Sydney, New South Wales, Australia
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Alison Mahoney
- Clinical Research Unit for Anxiety and Depression, St Vincent’s Hospital, Darlinghurst, Sydney, New South Wales, Australia
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| |
Collapse
|
46
|
Bartlett L, Martin AJ, Kilpatrick M, Otahal P, Sanderson K, Neil AL. Effects of a Mindfulness App on Employee Stress in an Australian Public Sector Workforce: Randomized Controlled Trial. JMIR Mhealth Uhealth 2022; 10:e30272. [PMID: 35142630 PMCID: PMC8874803 DOI: 10.2196/30272] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 09/22/2021] [Accepted: 12/20/2021] [Indexed: 01/19/2023] Open
Abstract
Background Workplace-based mindfulness programs have good evidence for improving employee stress and mental health outcomes, but less is known about their effects on productivity and citizenship behaviors. Most of the available evidence is derived from studies of mindfulness programs that use class-based approaches. Mindfulness apps can increase access to training, but whether self-directed app use is sufficient to realize benefits equivalent to class-based mindfulness programs is unknown. Objective We assessed the effectiveness of a mindfulness app, both with and without supporting classes, for reducing employees’ perceived stress. Changes in mindfulness, mental health, quality of life, perceptions of job demand, control and support, productivity indicators, organizational citizenship, and mindful behaviors at work were also investigated. Methods Tasmanian State Service employees were invited by the Tasmanian Training Consortium to a 3-arm randomized controlled trial investigating the effects of a mindfulness app on stress. The app used in the Smiling Mind Workplace Program formed the basis of the intervention. The app includes lessons, activities, and guided meditations, and is supported by 4 instructional emails delivered over 8 weeks. Engagement with the app for 10-20 minutes, 5 days a week, was recommended. Reported data were collected at baseline (time point 0), 3 months from baseline (time point 1 [T1]), and at 6-month follow-up (time point 2). At time point 0, participants could nominate a work-based observer to answer surveys about participants’ behaviors. Eligible participants (n=211) were randomly assigned to self-guided app use plus four 1-hour classes (app+classes: 70/211, 33.2%), self-guided app use (app-only: 71/211, 33.6%), or waitlist control (WLC; 70/211, 33.2%). Linear mixed effects models were used to assess changes in the active groups compared with the WLC at T1 and for a head-to-head comparison of the app+classes and app-only groups at follow-up. Results App use time was considerably lower than recommended (app+classes: 120/343 minutes; app-only: 45/343 minutes). Compared with the WLC at T1, no significant change in perceived stress was observed in either active group. However, the app+classes group reported lower psychological distress (β=−1.77, SE 0.75; P=.02; Cohen d=–0.21) and higher mindfulness (β=.31, SE 0.12; P=.01; Cohen d=0.19). These effects were retained in the app+classes group at 6 months. No significant changes were observed for the app-only group or for other outcomes. There were no significant changes in observer measures at T1, but by time point 2, the app+classes participants were more noticeably mindful and altruistic at work than app-only participants. Conclusions Including classes in the training protocol appears to have motivated engagement and led to benefits, whereas self-guided app use did not realize any significant results. Effect sizes were smaller and less consistent than meta-estimates for class-based mindfulness training. Trial Registration Australian New Zealand Clinical Trials Register ACTRN12617001386325; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=372942&isReview
Collapse
Affiliation(s)
- Larissa Bartlett
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Australia
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Angela J Martin
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Michelle Kilpatrick
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Petr Otahal
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Kristy Sanderson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
- School of Health Sciences, University of East Anglia, Norwich, United Kingdom
| | - Amanda L Neil
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| |
Collapse
|
47
|
Bradley DF, Ching TH, Languido L, Brady RE. Application of a Quality Improvement Process to Evaluate Self-Directed Therapy for Patients on a Waitlist in an Outpatient Anxiety Disorders Specialty Clinic. COGNITIVE AND BEHAVIORAL PRACTICE 2022. [DOI: 10.1016/j.cbpra.2021.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
48
|
Liu Z, Li M, Jia Y, Wang S, Zheng L, Wang C, Chen L. A randomized clinical trial of guided self-help intervention based on mindfulness for patients with hepatocellular carcinoma: effects and mechanisms. Jpn J Clin Oncol 2022; 52:227-236. [PMID: 35088079 DOI: 10.1093/jjco/hyab198] [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: 08/12/2021] [Accepted: 11/26/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Compared with face-to-face mindfulness-based interventions (MBIs), online mindfulness interventions may be more convenient for patients with limited resources and can provide self-help mindfulness methods to improve the quality of life of cancer patients. This study investigated the effects of guided self-help mindfulness-based interventions (GSH-MBIs) on psychological distress, quality of life and sleep quality in patients with hepatocellular carcinoma and explored the underlying mechanisms. METHODS A total of 122 patients with hepatocellular carcinoma were randomly divided into the intervention group or the conventional treatment group. Psychological distress, quality of life, sleep quality, psychological flexibility and perceived stress were evaluated in the groups before the intervention at baseline, after the intervention, at 1-month follow-up and 3-month follow-up. The intervention's effects over time and the potential mediating effects were analysed using generalized estimating equations (GEE). RESULTS GEE results indicated significant time-group interaction effects on psychological distress (P < 0.001) and sleep quality (P < 0.001). The intervention significantly improved psychological flexibility (β, -2.066; 95% CI, -3.631, -0.500) and reduced perceived stress (β, -2.639; 95% CI, -4.110, -1.169). Psychological flexibility and perceived stress played a mediating role in the observed results. CONCLUSION GSH-MBIs can improve psychological distress and sleep quality via changing the psychological flexibility and perceived stress in hepatocellular carcinoma patients.
Collapse
Affiliation(s)
- Zengxia Liu
- School of Nursing, Jilin University, Changchun
- School of Nursing, Changchun University of Chinese Medicine, Changchun
| | - Min Li
- Invasive Technology Department, The First Hospital of Jilin University, Changchun, China
| | - Yong Jia
- School of Nursing, Jilin University, Changchun
| | - Shuo Wang
- School of Nursing, Jilin University, Changchun
| | | | - Cong Wang
- School of Nursing, Jilin University, Changchun
| | - Li Chen
- School of Nursing, Jilin University, Changchun
| |
Collapse
|
49
|
Mechanisms Underlying Cognitive Effects of Inducing a Mindful State. J Cogn 2022; 5:13. [PMID: 36072102 PMCID: PMC9400668 DOI: 10.5334/joc.205] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 12/26/2021] [Indexed: 12/03/2022] Open
Abstract
Mindfulness is understood as a state or practice of guiding attention to the present moment without judgment. While some studies on mindfulness-based interventions demonstrate beneficial effects on cognitive functions (e.g. Chiesa et al., 2011; Yakobi et al., 2021) it still appears challenging to identify underlying mechanisms due to the wide range of research designs and dependent measures used, as well as the frequent absence of active control conditions. Relatedly, processes underlying the effects of short inductions of a mindful state may be unspecific to mindfulness and attainable through other means, such as relaxation (Fell et al., 2010). Therefore, the current study compared the effects of a brief mindfulness induction with a relaxation induction (via progressive muscle relaxation; active control condition) and listening to podcasts (passive control condition) in a pre-post experimental design. 78 participants without recent meditation experience were randomly assigned to the experimental conditions (mindfulness = 25; progressive muscle relaxation = 24; podcast listening = 30) and received corresponding instructions for a total of 40 minutes (2 × 20 minutes) a maximum of 3 days apart. Executive functions of inhibition, updating and switching as well as attentional networks were assessed with the continuous performance task, n-back task, number-letter task, and attention network task, respectively. While updating and executive attention similarly benefited from meditation and relaxation compared to podcast listening, inhibition and shifting measures indicate differential effects of mindfulness induction. Alerting and orienting were not affected by any induction. Implications for mechanisms underlying the effects of mindfulness are discussed.
Collapse
|
50
|
Levin ME, Hicks ET, Krafft J. Pilot evaluation of the stop, breathe & think mindfulness app for student clients on a college counseling center waitlist. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:165-173. [PMID: 32150519 DOI: 10.1080/07448481.2020.1728281] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 12/16/2019] [Accepted: 02/02/2020] [Indexed: 06/10/2023]
Abstract
Objectives: College counseling centers face significant challenges meeting the mental health needs of their students and waitlists are common. Mobile apps offer a promising solution to increase access to resources while students wait for services. Methods: This pilot randomized controlled trial evaluated the feasibility and acceptability of a publicly available mindfulness app. Students on a counseling center waitlist (n = 23) were randomized to use the app or not, with assessments completed over four weeks. Results: Recruitment over three semesters was slow, leading to an underpowered trial. Participants reported high satisfaction and moderate app usage. Very preliminary support was found for potential app efficacy relative to the control condition, particularly for depression, anxiety, and overall distress. Weaker, mixed effects were found for mindfulness and values processes. Conclusions: Overall, these results provide mixed findings suggesting the potential benefits, but also challenges in using a mindfulness app for students waiting to receive counseling services.
Collapse
Affiliation(s)
- Michael E Levin
- Department of Psychology, Utah State University, Logan, Utah, USA
| | | | - Jennifer Krafft
- Department of Psychology, Utah State University, Logan, Utah, USA
| |
Collapse
|