Effect of yoga nidra on the self-esteem and body image of burn patients

Development of audio-guided deep breathing and auditory Go/No-Go task on evaluating its impact on the wellness of young adults: a pilot study

OBJECTIVES

Numerous studies indicate that deep breathing (DB) enhances wellbeing. Multiple deep breathing methods exist, but few employ audio to reach similar results. This study developed audio-guided DB and evaluated its immediate impacts on healthy population via self-created auditory Go/No-Go task, tidal volume changes, and psychological measures.

METHODS

Audio-guided DB with natural sounds to guide the DB was developed. Meanwhile, audio-based Go/No-Go paradigm with Arduino was built to measure the attention level. Thirty-two healthy young adults (n=32) were recruited. Psychological questionnaires (Rosenberg's Self-Esteem Scale (RSES), Cognitive and Affective Mindfulness Scale-Revised (CAMS-R), Perceived Stress Scale (PSS)), objective measurements with tidal volume and attention level with auditory Go/No-Go task were conducted before and after 5 min of DB.

RESULTS

Results showed a significant increment in tidal volume and task reaction time from baseline (p=0.003 and p=0.033, respectively). Significant correlations were acquired between (1) task accuracy with commission error (r=-0.905), (2) CAMS-R with task accuracy (r=-0.425), commission error (r=0.53), omission error (r=0.395) and PSS (r=-0.477), and (3) RSES with task reaction time (r=-0.47), task accuracy (r=-0.362), PSS (r=-0.552) and CAMS-R (r=0.591).

CONCLUSIONS

This pilot study suggests a link between it and young adults' wellbeing and proposes auditory Go/No-Go task for assessing attention across various groups while maintaining physical and mental wellness.

Effects of a music-based exercise program on the postural balance and emotions of instrumentalists

This study aimed to verify the effects of a music-based exercise program on postural balance and emotional factors among instrumentalists. We recruited 11 instrumentalists aged 25-45 years who were asked to perform a music-based exercise program for 60 min per session, three sessions weekly, for 8 weeks. The anterior balance and lateral alignment of the participants were determined using a body posture analyzer. To assess the emotional factors, the World Health Organization Quality of Life, stress response inventory, and Rosenberg self-esteem scale were used. This study did not reveal a statistically significant difference in anterior postural imbalance and lateral misalignment. In contrast, emotional factors, including quality of life, stress response, and the self-esteem subcategories, exhibited significant differences. The music-based exercise program in this study significantly improved the emotional factors. Nevertheless, a more structured and long-term program should be developed to ensure the improvement of postural imbalance among instrumentalists.

Yoga Nidra, a Nonpharmacological Technique in Management of Insomnia and Overall Health in Postmenopausal Women

Yoga Nidra is a promising technique through which body is consciously simulated into a profound relaxation state similar to attained during naturally occurring deep sleep. It is aimed to attain complete emotional, physical, and mental relaxation of body and mind. In postmenopausal phase of life, regular practice of Yoga Nidra at home preferably in morning, can help in reduction in anxiety and pain associated with early morning awakenings. This nonpharmacological technique has a therapeutic potential to improve sleep quality and quantity, and overall well-being.

Exploring the uses of yoga nidra: An integrative review

AIM

The purpose of this paper was to review and synthesize published research articles that have utilized yoga nidra as an intervention.

BACKGROUND

Yoga nidra is a form of guided meditation that has emerged in the literature in the past two decades as an intervention for a variety of medical conditions such as stress and mental health. It differs from traditional yoga, in that it does not require yoga poses. It is a noninvasive, cost-effective approach that is also easily accessible so it can be done in the privacy and comfort of the home.

DESIGN

The integrative review methodology by Whittemore and Knafl (2005) provided the framework for this review.

METHODS

The databases CINAHL, PubMed, SCOPUS, and PsycINFO were used to search for articles. Inclusion criteria consisted of journal articles in English with no limitations on dates of publication. Studies were excluded if any form of traditional yoga requiring poses was used as an intervention. Also excluded were all types of meditation that were not yoga nidra, systematic reviews, studies that utilized multiple intervention types (i.e., traditional yoga and yoga nidra), and commentaries/brief reports. Twenty-nine studies met the inclusion criteria. Quality appraisal was completed for each study.

RESULTS

The 29 studies that were reviewed consisted of 12 randomized controlled trials, 13 quasi-experimental studies, 3 mixed-methods studies, and 1 qualitative study. Outcome variables were categorized according to themes and results were systemically synthesized and reported by theme: (a) stress, (b) mood, (c) well-being, (d) psychologic dysfunction, (e) biomarkers, (f) sleep, and (g) miscellaneous.

CONCLUSION

Yoga nidra was found to be effective in most of these studies. However, there was some clinical heterogeneity in the sample populations and intervention session lengths, frequencies, and durations, making it difficult to draw conclusions about yoga nidra intervention based solely on the findings presented in this review. More studies are needed overall, particularly ones with larger sample sizes and stronger experimental designs.

CLINICAL RELEVANCE

Yoga nidra has the potential to be a useful, noninvasive, nonpharmacologic treatment or adjunct for a variety of conditions, particularly mental health.

Comparison of the effects of Benson relaxation technique and nature sounds on pain, anxiety, and body image in burn-injured patients admitted to the burn ICU: A single-blind randomized clinical trial

BACKGROUND

Burn patients feel a lot of physiological and mental stress during treatment and rehabilitation which often cause anxiety and body image dissatisfaction. This study aimed to compare the effects of the Benson relaxation technique and nature sounds on pain anxiety and body image in burn-injured patients admitted to a burn intensive care unit (BICU).

METHODS

This single-blind randomized clinical trial studied 60 burn patients allocated into three groups (Benson relaxation, nature sounds, and control) from September 2021 to February 2022. The patients received the intervention for seven consecutive days in person. Burn Specific Pain Anxiety Scale (BSPAS), was completed on the 1st, 4th, and 7th days. The intervention continued for four weeks measuring body image using the Satisfaction with Appearance Scale (SWAP) at the end of the 1st, 3rd, and 5th weeks. Finally, the data were statistically analyzed using the Shapiro-Wilk test, chi-square test, Fisher's exact test, Bonferroni post hoc test, repeated measures ANOVA, Kruskal Wallis test, and Generalize Estimating Equations (GEE).

RESULTS

The mean pain anxiety and dissatisfaction with the appearance were high in the three groups in the pretest. On the 7th day after the intervention, the ANOVA showed that the mean pain anxiety decreased significantly in Benson's relaxation and nature sounds groups in three stages (before intervention (S1), after intervention (S2) and immediately after dressing change (S3) (P < 0.001). Correspondingly, the Kruskal Wallis test revealed that the body image dissatisfaction decreased significantly in the three groups at the end of the 3rd and 5th weeks (P < 0.001). The mean scores of pain anxiety showed that the nature sounds group proved more effective than the Benson relaxation technique. Also, the means scores of body image satisfaction showed that the Benson relaxation technique proved more effective than nature sounds.

CONCLUSION

The study findings suggested that the Benson relaxation technique and nature sounds effectively reduces pain, anxiety, and improves body image satisfaction in patients with burn injuries.

Meditation practices and their relationship with eating behavior, weight changes, and mental health in adults from different regions of Brazil: A cross-sectional study

OBJECTIVES

This study aimed to evaluate the effect of different meditation practices on eating behavior, changes in body weight, and mental health.

METHODS

A virtual questionnaire was used to evaluate meditation practices and current and prepandemic weights. The questionnaire comprised specific and validated instruments to evaluate body image (silhouette scale), eating behavior (21-item three-factor eating questionnaire), current sleep quality (Pittsburgh Sleep Quality Index), and anxiety (Beck Anxiety Inventory). Initially, data from all the respondents were assessed (n = 764). Mindfulness was the most common type of meditation practice in most Brazilian regions.

RESULTS

Lower scores in uncontrolled eating (meditation practitioners = 32.19 ± 19.72 and non-meditation practitioners = 35.17 ± 20.50; P = 0.038) and higher weight loss (meditation practitioners = -0.77 ± 8.44 and non-meditation practitioners = 1.29 ± 6.39; P = 0.013) were observed among those who practiced some type of meditation. To verify the influence of weight, we analyzed the data of individuals who had body mass index ≥25 kg/m²; overweight individuals presented lower uncontrolled eating scores when they practiced meditation. However, no statistical difference was observed between meditation practitioners and non-practitioners when only adequate weight individuals were evaluated. The practice also influenced the perception of body image among men and resulted in lower uncontrolled eating scores on the 21-item three-factor eating questionnaire and greater weight loss during the pandemic among women. Those practicing meditation for >13 mo had a lower final score on the anxiety assessment instrument compared with those practicing for <12 mo (P = 0.002).

CONCLUSIONS

The findings indicate that the inclusion of meditation practice as part of the management of overweight may reduce dysfunctional eating behaviors and negative emotions, thereby contributing to weight loss, especially in the long term.

A systematic review of self-esteem and related factors among burns patients

Introduction

The present systematic review was conducted to examine self-esteem and related factors in burns patients.

Methods

A comprehensive search was conducted from the first to the April 1, 2022 at the international electronic databases such as Scopus, PubMed, Web of Science, and Persian electronic databases such as Iranmedex, and Scientific Information Database using keywords extracted from Medical Subject Headings such as "Burns", "Self-confidence", "Self-perception", "Self-esteem", and "Self-concept".

Results

A total of 762 burn patients were included in this review from ten cross-sectional studies. The mean score of self-esteem in burn patients based on Rosenberg Self-Esteem Scale, State Self-Esteem Scale, Cooper Smith's self-esteem questionnaire, and Rifai's self-esteem scale were 17.77 (SD = 5.55) out of 30, 65.91 (SD = 5.49) out of 100, 56.68 (SD = 5.49) out of 100, and 109.77 (SD = 9.55) out of 145, respectively. Factors associated with self-esteem in burns patients were gender, occupation, the location of the burn, type of burn, site of burn, burn scar, and quality of life had a significant relationship with burn patients' self-esteem. Factors such as social support, family support, friends support, and supporting others, had a significant positive relationship with self-esteem of burns patient. However, self-esteem in patients with burn had a significant negative relationship with grade of burn injury, percentage of burn, depth of burn, facial burn, post-traumatic stress disorder, psychiatric morbidity, major depressive, and suicidality factors.

Conclusion

Overall, patients with burns had moderate levels of self-esteem. Therefore, it is recommended that health professionals use interdisciplinary approaches to better manage burn patients.

Psychotherapeutic interventions for burns patients and the potential use with Stevens-Johnson syndrome and toxic epidermal necrolysis patients: A systematic integrative review

Background

The existing evidence demonstrates that survivors of SJS/TEN have reported long-lasting psychological effects of their condition. Burns patients experience similar psychological effects. It is important to look at ways to help allay the psychological complications of SJS/TEN. As there is an absence of evidence on SJS/TEN psychotherapeutic interventions, it was judged to be beneficial to determine the evidence underpinning psychotherapeutic interventions used with burns patients.

Aims and objectives

The aim of this systematic integrative review was to synthesize the evidence relating to psychotherapeutic interventions used with adult burns patients and patients with SJS/TEN.

Method

The systematic review was guided by Whittemore and Knafl’s integrative review process and the PRISMA guidelines. Nine databases were searched for English and French language papers published January 2008 to January 2021. The protocol for the review was registered with PROSPERO.

Results

Following a screening process, 17 studies were included in the review. Two themes were identified using content analysis, (i) Empirically supported psychotherapeutic treatments, (ii) Alternative psychotherapeutic treatments. This review revealed no evidence on specific psychotherapeutic interventions for patients with SJS/TEN. Some of the interventions used with burns patients, viz. relaxation therapy, hypnosis and cognitive behavioral therapy showed some significant benefits. However, the evidence for burns patients is mainly focused on pain and pain anxiety as outcomes.

Conclusion

Following further research, some of the interventions deployed in burns patients may be applicable to SJS/TEN patients, particularly stress reduction techniques. In addition, the caring behaviours such as compassion, respect, and getting to know the patient as a person are important components to psychological care.

Adjunctive Nonpharmacologic Interventions for the Management of Burn Pain: A Systematic Review

BACKGROUND

The conventional way of treating burn victims with mainstream pain control modalities is costly and has many negative side effects. In this study, the authors aim to present the findings from the major clinical trials on three nonpharmacologic interventions-hypnosis, virtual/augmented reality, and yoga-as supplements to conventional pain regimens for burn management.

METHODS

A computerized literature search was conducted of the PubMed and ClinicalTrials.gov databases in April of 2020. The online screening process was performed by two independent reviewers with the Covidence tool. The protocol was reported using the Preferred Reporting Items for Systematic Review and Meta-Analyses, and it was registered at the International Prospective Register of Systematic Reviews of the National Institute for Health Research.

RESULTS

The search yielded 254 articles from 1955 to 2020. Fifty-eight studies met the authors' inclusion criteria. Yoga reduced cognitive and somatic anxiety in burn survivors, and improved body image. Virtual reality is effective in pain reduction in both the pediatric and the adult burn population, and in faster burn wound reepithelialization. Hypnosis has similar results regarding reducing pain quality and anxiety in burn patients undergoing burn wound care and dressing changes but was not found to significantly accelerate the healing process.

CONCLUSIONS

Nonpharmacologic interventions are not a substitute for conventional analgesics; however, they could help patients have better control over their pain, greater self-esteem, and less postburn traumatic experiences. Burn care centers should consider nonpharmacologic interventions to improve patient satisfaction and their participation in the treatment and rehabilitation process.

Yoga therapy as an adjunct to conventional management of systemic sclerosis: A case series

Systemic sclerosis (SSc) is an autoimmune disorder leading to significant disability and loss of Quality of Life (QoL). Yoga has become popular in recent times for its potential therapeutic benefits. Since there are no scientific reports on the use of Yoga for SSc, we present two female cases (aged 49 and 29 respectively) of limited SSc (duration of illness 4 and 3 years respectively) who underwent Yoga therapy as an adjunct to conventional management in a residential setting for a period of five and four weeks, respectively. During their stay, they underwent a specifically designed Yoga module. After their discharge, they were followed-up for four weeks, during which they were asked to continue practicing Yoga for 1 h every day. Both of them reported a reduction in pain, stiffness, symptom scores, and improved QoL on discharge and at the follow-up compared to the values on admission. Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP), as biomarkers of inflammation, reduced on the discharge when compared to the baseline. No adverse events were noted during the stay and the follow-up. Thus, the present case series indicate a possible beneficial role of Yoga as an adjunct therapy to conventional management of SSc. Further studies in the area are warranted to ascertain the efficacy of Yoga for SSc.

Yogic Sleep and Walking Protocol Induced Improvement in Sleep and Wellbeing in Post-menopausal Subject: A Longitudinal Case Study During COVID Lockdown

Purpose

Post-menopausal life is fairly long period of life that is marked by poor health and sleep. Fatigue amidst extraordinary pandemic stress had taken a toll on the sleep quality and overall wellbeing. Yogic sleep can be instrumental in relaxing the brain and help in achieving self-control of mind and body in the post-menopausal life. This can be a non-pharmacological intervention to improve the wellbeing of women.

Methods

Effect of 24 weeks of yoga-nidra practice and exercise module was tested in a post-menopausal subject after taking baseline of 4 weeks on parameters like sleep latency, total sleep time, mood on waking and during day, BMI, and activity rhythm of body using 24 h actigraphy and sleep diary.

Results

After administering the dual protocol, there was remarkable elevation in mood both on waking up and entire day from 5th week onwards. Mood shifted toward a happier state. Latency to sleep decreased after 4 weeks, while total sleep time improved only after 16 weeks of dual management strategy. The BMI was also reduced to 28.4 from initial value of 30.3. Morning awakening patterns did not change, but it was not accompanied by pain or headache.

Conclusion

The results indicated the therapeutic potential of yoga-nidra and exercise package in this actigraphy-based longitudinal pilot study. Yoga-nidra can be easily practiced at home, and thus, it is a promising non-pharmacological strategy for aging population in improving their wellbeing.

Effectiveness of Yoga Nidra in reducing stress in school going adolescents: An experimental study

BACKGROUND AND OBJECTIVES

Academic stress can exert severe stress in adolescents answering their career deciding board exams. The present study attempted to understand the efficacy of Yoga Nidra (YN) in mitigating psychosocial stress.

DESIGN

and Methods: This study was carried on 10th-grade students (ages 14 to 16) and had two arms, one performing YN (experimental) and the other without YN (control) for 21 consecutive days. Modified Adolescent Stress Questionnaire (ASQ-I) was used to assess the stress in the students before and after the intervention.

RESULTS

The results indicate that performing YN was effective and significantly decreased the total stress (P < 0.001) and vital domains like the stress of home life (P < 0.005), school performance (P < 0.026), teacher interaction (P < 0.024), future uncertainty (P < 0.001), school and leisure conflict (P < 0.001). Also, at the end of the study in control, low and moderate stress was observed in 58.06% and 41.93%, while in the YN group, it was 96.15% and 3.85% and was statistically significant (p < 0.001).

CONCLUSIONS

This study shows that YN effectively reduced psychosocial stress in adolescents and could be useful in school curriculum.

Religiosity, spirituality, and self-esteem in adolescents with cleft lip and palate: a correlational study

OBJECTIVE

To evaluate the correlation between religiosity, spirituality, and self-esteem in adolescents with uni- and bilateral cleft lip and palate.

METHOD

Correlational and cross-sectional study developed in a public and tertiary hospital in Brazil between July 2018 and February 2019. The sample comprised 100 adolescents divided into two groups: G1 (unilateral cleft, 50 participants) and G2 (bilateral cleft, 50 participants). For data collection, three instruments were used: Sociodemographic Questionnaire, DUREL Religion index, Rosenberg self-esteem scale. Statistical analysis was performed with the tests Chi-squared, Mann-Whitney, Pearson Correlation, and analysis of linear correlation strength, with a 5% significance level (p ≥ 0.05).

RESULTS

Only organizational religiosity was higher in G1 when compared with G2 (p = 0.03). The overall self-esteem was satisfactory for both groups; however, there was no significant difference between them (p = 0.34). No correlation between religiosity and spirituality with self-esteem were identified for G1 and G2.

CONCLUSION

The adolescents with uni- or bilateral cleft lip and palate presented high levels of religiosity, spirituality, and self-esteem. However, no correlation between these variables was identified.