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Ferris France N, Byrne E, Nyamwanza O, Munatsi V, Willis N, Conroy R, Vumbunu S, Chinembiri M, Maedziso S, Katsande MA, Dongo TA, Crehan E, Mavhu W. Wakakosha "You are Worth it": reported impact of a community-based, peer-led HIV self-stigma intervention to improve self-worth and wellbeing among young people living with HIV in Zimbabwe. Front Public Health 2023; 11:1235150. [PMID: 37575105 PMCID: PMC10422020 DOI: 10.3389/fpubh.2023.1235150] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 07/18/2023] [Indexed: 08/15/2023] Open
Abstract
Introduction Self-stigma-negative self-judgements or core beliefs-can result in feelings of shame, worthlessness and self-blame, and impacts social interaction, mental health and health service utilization among people living with HIV (PLHIV). Few interventions target self-stigma among PLHIV and, to our knowledge, none until now for adolescents and young people LHIV (AYPLHIV) in sub-Saharan Africa. We present qualitative findings on the perceived impact of a self-stigma intervention (Wakakosha, "You are Worth it"). Methods The Wakakosha intervention adopted inquiry-based stress reduction (IBSR) at its core-a unique way of identifying and questioning deeply rooted self-stigma, combined with mindfulness, meditation and creativity. The intervention consisted of 16 × 3 hour group sessions. Supporting the intervention was a 156-page activity journal. We utilized a qualitative enquiry to explore the perceived impact of the intervention at various time points between November 2021 and November 2022, with 62 participants (n = 32 female). Discussions explored experiences of being involved in the intervention and any reports on changes in relation to self-stigma and shame. Additionally, we reviewed intervention documentation and creative elements. A thematic analysis guided generation of themes across all data sources. Results Both intervention participants and coaches described the transformative effect of the intervention, detailing their experiences before and after. Main themes that emerged were positive changes around: self-confidence, self-agency, sense of purpose/meaning, body positivity, improved communication and personal/family relationships and, forgiveness. The intervention also transferred a set of practical skills on self-inquiry, mindfulness, meditation and creativity that continued to be used in participants' daily lives. Conclusion The Wakakosha intervention, using IBSR supported by music, creativity, writing and mindfulness techniques, showed potential for reducing self-stigma and improving self-worth among AYPLHIV. It also transferred practical skills to intervention participants and peer coaches, building their capacity to support others and deal with life challenges beyond HIV. The next phase is to continue supporting the young people to ensure fidelity as the peer coaches deliver the intervention to others. Study results indicate that culturally and practically, interventions to reduce self-stigma and/or improve self-worth operate at various levels and need to be designed and assessed at each level.
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Affiliation(s)
- Nadine Ferris France
- Beyond Stigma, Dublin, Ireland
- University College Cork School of Medicine, Department of Public Health & Epidemiology, Cork, Ireland
| | - Elaine Byrne
- Centre for Positive Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Owen Nyamwanza
- Centre for Sexual Health and HIV/AIDS Research (CeSHHAR), Harare, Zimbabwe
| | | | | | - Ronan Conroy
- Department of Epidemiology and Public Health, Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | - Moud Chinembiri
- Community of the Work in Zimbabwe, Harare, Zimbabwe
- The Work Under the Tree Trust, Harare, Zimbabwe
| | | | | | | | | | - Webster Mavhu
- Centre for Sexual Health and HIV/AIDS Research (CeSHHAR), Harare, Zimbabwe
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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Landau C, Novak AM, Ganz AB, Rolnik B, Friedman E, Lev-Ari S. Effect of Inquiry-Based Stress Reduction on Well-being and Views on Risk-Reducing Surgery Among Women With BRCA Variants in Israel: A Randomized Clinical Trial. JAMA Netw Open 2021; 4:e2139670. [PMID: 34962562 PMCID: PMC8715352 DOI: 10.1001/jamanetworkopen.2021.39670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
IMPORTANCE The high risk for breast and ovarian cancers conferred by being a carrier of BRCA1 or BRCA2 germline variant can negatively impact physical and psychological well-being. Novel nonpharmacological interventions on well-being in women with BRCA variants have rarely been reported. OBJECTIVE To determine the effect of a 12-week inquiry-based stress reduction (IBSR) program on psychological well-being, sleep quality, psychosocial variables, and attitudes toward risk-reducing surgical procedures among women in Israel who carried BRCA variants. DESIGN, SETTING, AND PARTICIPANTS This randomized clinical trial had a 12-week intervention period and a 12-week follow-up period. It was conducted between April 1, 2017, and July 31, 2020. Participants were recruited from the Meirav Breast Center at the Sheba Medical Center, Israel, and the intervention was conducted in Tel Aviv, Israel. The cohort included women with BRCA variants. Data were analyzed from August 1 to December 1, 2020. INTERVENTIONS Women were randomly assigned to the 12-week IBSR program or standard care. The IBSR technique is based on the skills of mindfulness, inquiry, and cognitive reframing. The intervention included standardized, weekly group meetings conducted throughout 12 weeks. Standard care included semi-annual breast examinations and breast magnetic resonance imaging (alternating), a gynecological examination, a transvaginal ultrasonographic examination, and CA-125 serum determination. Differences between the groups were tested using mixed-effects models in an intent to treat analysis. MAIN OUTCOMES AND MEASURES The primary outcome was psychological well-being, including 6 parameters: autonomy, personal growth, positive relationships, control of the environment, goals in life, and self-acceptance. Secondary outcomes included sleep quality, attitudes toward risk-reducing surgical procedures, and psychosocial variables. Questionnaires were administered at baseline (T1), at completion of the 12-week intervention (T2), and 12 weeks after completion of the intervention (T3). RESULTS Overall, 100 women (mean [SD] age, 41.37 [11.06] years) completed the study, with 50 randomized to the intervention group and 50 randomized to the control group. Mean (SD) time from variant discovery was 4.7 (3.3) years. There were no differences between the intervention and control groups in baseline mean (SD) scores of psychological well-being parameters (autonomy: 55.20 [11.12] vs 56.77 [9.90]; environmental control: 56.30 [11.98 vs 58.51 [11.41]; positive relationships: 63.10 [15.91] vs 68.10 [9.86]; goals in life: 60.00 [14.12] vs 64.82 [10.57]; self-acceptance: 55.02 [16.62] vs 60.32 [13.50]) except personal growth (63.70 [14.66] vs 68.85 [8.07]). The IBSR group, compared with the control group, experienced better mean (SD) scores on all psychological well-being parameters at T2 (autonomy: 63.64 [8.35] vs 54.73 [10.41]; environmental control: 63.95 [10.05] vs 57.45 [11.43]; personal growth: 73.00 [8.34] vs 65.76 [10.95]; positive relationships 71.17 [9.99] vs 65.06 [12.58]; goals in life: 67.57 [8.88] vs 61.18 [12.87]; self-acceptance: 66.93 [11.15] vs 58.09 [15.55]) and at T3 (autonomy: 62.68 [9.05] vs 56.12 [10.64]; environmental control: 64.55 [10.28] vs 59.35 [12.98]; personal growth: 72.00 [8.06] vs 67.15 [11.82]; positive relationships: 71.24 [9.78] vs 66.92 [12.37]; goals in life: 68.33 [8.54] vs 62.92 [13.24]; self-acceptance: 66.84 [11.35] vs 58.97 [17.03]). Individuals in the IBSR group also experienced statistically significant improvements in sleep quality (mean [SD]: T1, 7.35 [3.97]; T3, 4.63 [3.21], P < .001), whereas the control group experienced no statistically significant difference. Women in the intervention group had a more favorable consideration of risk-reducing oophorectomy, from 7 women (14%) who refused to consider oophorectomy at T1 to 1 woman (2%) who refused to consider it at T3 (P = .04), and similar change in consideration of mastectomy: from 23 women (46%) who refused to consider mastectomy at T1 to 13 women (29%) who refused to consider it at T3 (P < .001). CONCLUSIONS AND RELEVANCE This randomized clinical trial found that IBSR improved psychological well-being and led to a more favorable view on risk-reducing surgical procedures for at least 6 months among women in Israel who carried BRCA variants. These results suggest that IBSR may be implemented as a self-practice tool to enhance the well-being of individuals who carry BRCA variants and support them in their decision-making processes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03162276.
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Affiliation(s)
- Carla Landau
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Anne Marie Novak
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ariel B. Ganz
- Department of Genetics, Stanford University School of Medicine, Stanford, California
| | - Benjamin Rolnik
- Department of Genetics, Stanford University School of Medicine, Stanford, California
| | - Eitan Friedman
- Suzanne Levy-Gertner Oncogenetics Unit, Sheba Medical Center, Ramat Gan, Israel
| | - Shahar Lev-Ari
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Álvarez ÓS, Ruiz-Cantero MT, Cassetti V, Cofiño R, Álvarez-Dardet C. Salutogenic interventions and health effects: a scoping review of the literature. GACETA SANITARIA 2021; 35:488-494. [DOI: 10.1016/j.gaceta.2019.12.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 12/05/2019] [Accepted: 12/16/2019] [Indexed: 11/26/2022]
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Feldman O, Goldstien E, Rolnik B, Ganz AB, Lev-Ari S. Inquiry Based Stress Reduction (IBSR) Improves Overall Stuttering Experience among Adults Who Stutter: A Randomized Controlled Trial. J Clin Med 2021; 10:2187. [PMID: 34070161 PMCID: PMC8158472 DOI: 10.3390/jcm10102187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 05/04/2021] [Accepted: 05/07/2021] [Indexed: 12/27/2022] Open
Abstract
Stuttering is a speech disorder that can cause disturbances in the timing and flow of speech. In addition to being a communication disorder, stuttering is often accompanied by a reduction in the quality of life and has impacts on social status, mental well-being, self-acceptance, and the chances of integration into the labor market. The Inquiry Based Stress Reduction (IBSR) program, developed in the United States by Byron Katie in 1986, is the clinical application of "The Work" method (Thework.com) and represents an emerging mindfulness and cognitive-reframing method. IBSR has been demonstrated to improve mental health and well-being in adults and may alleviate psychological and psychosocial symptoms of stuttering. The purpose of this trial was to examine the effect of a 12-week IBSR intervention on the overall stuttering experience and indicators of anxiety, psychological flexibility, and well-being among adults who stutter (AWS). This study was a randomized controlled clinical trial. Participants were randomized to IBSR (n = 28) and control (n = 28) groups. Validated questionnaires of overall stuttering experience (OASES-A), anxiety (STAI), psychological flexibility (PFQ), and satisfaction with life (SWLS) were completed before, after, and one month after the intervention. An intention-to-treat approach was implemented for analysis. Our results show that participants in the IBSR intervention group exhibited a greater improvement in their overall stuttering experience as compared to the control group, as well as in general information on stuttering awareness and perception, reactions to stuttering, communication in daily situations, and quality of life. In addition, we found a greater reduction in anxiety levels and an increase in satisfaction-with-life scores in the IBSR group. These results indicate that IBSR can improve the overall stuttering experience.
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Affiliation(s)
- Omrit Feldman
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel; (O.F.); (E.G.)
| | - Eran Goldstien
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel; (O.F.); (E.G.)
| | - Benjamin Rolnik
- Department of Genetics, Stanford University, Stanford, CA 94305, USA; (B.R.); (A.B.G.)
| | - Ariel B. Ganz
- Department of Genetics, Stanford University, Stanford, CA 94305, USA; (B.R.); (A.B.G.)
| | - Shahar Lev-Ari
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel; (O.F.); (E.G.)
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Effect of Inquiry-Based Stress Reduction (IBSR) Intervention on Well-Being, Resilience and Burnout of Teachers during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073689. [PMID: 33916258 PMCID: PMC8037267 DOI: 10.3390/ijerph18073689] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/23/2021] [Accepted: 03/27/2021] [Indexed: 01/07/2023]
Abstract
Objective: The COVID-19 pandemic has had a major impact on teachers professional and personal lives. Our primary aim was to assess the effect of a blended Inquiry-Based Stress Reduction (IBSR), an emerging mindfulness and cognitive reframing intervention on teacher's well-being. Our secondary aims were to assess the effect of IBSR on resilience, burnout, mindfulness, and stress among teachers during the COVID-19 pandemic. Methods: The study was a prospective controlled trial with an intervention group (N = 35) and a comparison control group (N = 32). The intervention took place in the Jerusalem District throughout the school year from November 2019 to May 2020. The sessions were conducted in blended learning that included traditional learning (face-to-face) and online learning. Data was analyzed on an intention-to-treat basis. Results: IBSR blended intervention enhanced the resilience and improved the subjective and psychological well-being of teachers in spite of the breakout of the COVID-19 pandemic and the first lockdown in Israel. Simultaneously the control group suffered from enhanced burnout levels and a decline in psychological and subjective well-being. Conclusions: Implementation of IBSR blended intervention during the school year may benefit teachers' well-being and ability to flourish, even during stressful events such as the COVID-19 pandemic.
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Hook JN, Kim Penberthy J, Davis DE, Van Tongeren DR. Inquiry-based stress reduction: A systematic review of the empirical literature. J Clin Psychol 2021; 77:1280-1295. [PMID: 33538339 DOI: 10.1002/jclp.23120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 12/11/2020] [Accepted: 01/20/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This paper reviewed the empirical research on inquiry-based stress reduction (IBSR; also called "The Work"), which has similarities to third-wave cognitive behavioral approaches such as Acceptance and Commitment Therapy (ACT). Widely used as a self-help intervention, IBSR has only recently been subjected to empirical research. METHOD We reviewed empirical studies (published and unpublished) that examined IBSR. RESULTS We found 17 empirical studies (15 independent samples) that examined IBSR. Several studies reported positive changes on variables such as stress, anxiety, and well-being. However, only three studies evaluated IBSR using randomized clinical trials (RCTs). Concerns related to treatment feasibility and cost-effectiveness of IBSR are noted. CONCLUSIONS There are some promising initial findings on IBSR. However, additional research employing high-quality research designs is necessary to explore the efficacy and effectiveness of IBSR in various contexts.
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Affiliation(s)
- Joshua N Hook
- Department of Psychology, University of North Texas, Denton, Texas, USA
| | - Jennifer Kim Penberthy
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, Virginia, USA
| | - Don E Davis
- Department of Counseling and Psychological Services, Georgia State University, Atlanta, Georgia, USA
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The Effect of Inquiry-Based Stress Reduction on Teacher Burnout: A Controlled Trial. Brain Sci 2020; 10:brainsci10070468. [PMID: 32708055 PMCID: PMC7407507 DOI: 10.3390/brainsci10070468] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 07/08/2020] [Accepted: 07/14/2020] [Indexed: 12/03/2022] Open
Abstract
Burnout is a well-known phenomenon with significant social, biological and economic costs. In particular, teacher burnout is associated with unfavorable mental health outcomes and economic costs due to reduced hours and teacher turnover. This study investigated the effect of an Inquiry-Based Stress Reduction (IBSR) cognitive-reframing program on teacher burnout using a quasi-experimental design. Fifty-three teachers participated in a prospective intervention with a passive control group. The intervention group completed a 12-week IBSR program with 4.5 h of weekly engagement. Relative to control, teachers in the intervention group showed greater improvements in emotional exhaustion (18.8 ± 5.2 to 15.9 ± 5.7 vs. 16.0 ± 4.8 to 17.4 ± 4.8; p = 0.01) and personal accomplishment (21.8 ± 5.0 to 24.6 ± 4.3 vs. 21.9 ± 4.5 to 22.8 ± 4.3; p = 0.04). Significant correlations were found between change in emotional exhaustion and negative affect (positive correlation; r = 0.32; p = 0.034) and between personal accomplishment and perceived stress (negative correlation; r = −0.451; p = 0.002). This study demonstrates the potential of IBSR to improve teacher well-being. Future randomized studies are needed to evaluate the causality of IBSR in reducing burnout among teachers and other high-stress workplaces.
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Ferris France N, Macdonald SHF, Conroy RR, Chiroro P, Ni Cheallaigh D, Nyamucheta M, Mapanda B, Shumba G, Mudede D, Byrne E. 'We are the change' - An innovative community-based response to address self-stigma: A pilot study focusing on people living with HIV in Zimbabwe. PLoS One 2019; 14:e0210152. [PMID: 30759114 PMCID: PMC6373928 DOI: 10.1371/journal.pone.0210152] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 12/17/2018] [Indexed: 12/31/2022] Open
Abstract
Introduction Self-stigma–negative self-judgements resulting in shame, worthlessness and self-blame–may play a crucial role in emotional reactions and cause emotional distress among many people living with HIV and other chronic illnesses. Furthermore, self-stigma negatively impacts on self-agency, quality of life, adherence to treatment, and access to services. High levels of self-stigma have been reported across many countries, however few programmes or interventions exist to specifically tackle this phenomenon. This paper reports the findings of a pilot study carried out in Zimbabwe using a programme incorporating “Inquiry-Based Stress Reduction (IBSR): The Work of Byron Katie”–a guided form of self-inquiry which helps users to overcome negative thoughts and beliefs. Objectives The primary objective of this uncontrolled pilot study was to examine the potential role of the IBSR intervention in helping people living with HIV to overcome self-stigma and associated states. Methods 23 people living with HIV (17 Female, 6 male, average age 41 years) were recruited from a local HIV support network, via open call for volunteers. All participants received the intervention, consisting of a 12-week facilitated programme using techniques derived from IBSR: The Work of Byron Katie. Qualitative and quantitative data were collected and analysed pre- and post-programme. Results After taking part in the intervention, participants reported significant improvements in factors including self-stigma (1-month follow-up vs baseline Z = 2.1, p = 0.039; 3-month follow-up vs baseline Z = 3.0, p = 0.003, n = 23, Wilcoxon Matched Pairs Signed Rank Test) and depression (1mo vs baseline Z = 3.7, p = <0.001; 3mo vs baseline Z = 3.3, p = 0.001). Qualitatively, participants reported improvements including lessened fears around disclosure of their HIV status, reduced feelings of life limitations due to HIV, and greater positive mentality. Improvements persisted at three-month follow-up. Conclusion With further development and larger comparative studies to confirm effects, the IBSR programme could become a novel tool to enable people living with HIV to support themselves in overcoming self-stigma.
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Affiliation(s)
- Nadine Ferris France
- The Work for Change / Irish Forum for Global Health, c/o Department of Epidemiology and Public Health Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Stephen H.-F. Macdonald
- The Work for Change / Irish Forum for Global Health, c/o Department of Epidemiology and Public Health Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
- * E-mail:
| | - Ronan R. Conroy
- Department of Epidemiology and Public Health Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | | | - Masimba Nyamucheta
- Zimbabwe National Network of People Living with HIV (ZNNP+), Harare, Zimbabwe
| | | | - Godsway Shumba
- Independent Consultant to Trócaire, Maynooth, Co. Kildare, Ireland
| | - Dennis Mudede
- Connect Zimbabwe Institute of Systemic Therapy (ZIST), Harare, Zimbabwe
| | - Elaine Byrne
- RCSI Institute of Leadership, Royal College of Surgeons in Ireland, Dublin, Ireland
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Krispenz A, Dickhäuser O. Reduction of Chronic Stress and Trait Anxiety by Inquiry of Cognitive Appraisals with the Inquiry-Based Stress Reduction (IBSR) Method. OPEN PSYCHOLOGY 2019. [DOI: 10.1515/psych-2018-0013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
AbstractBackground: Chronic stress and anxiety can impair individuals’ health. Appraisal theories assume that stress and anxiety are experienced if individuals appraise a situation as threatening for their well-being. Thus, the modification of cognitive appraisals can be expected to reduce stress and anxiety. A potentially effective method to modify individuals’ appraisals is inquiry-based stress reduction (IBSR; Mitchell & Mitchell, 2003).Aims: The present study assesses the effects of IBSR on chronic stress and trait anxiety in comparison to a matched control group.Method: We used a quasi-experimental repeated-measurement design and a non-clinical sample of N = 199. Participants’ chronic stress and anxiety levels were assessed before and three months after a nine-day IBSR training. To account for the consequences of missing randomization, propensity score matching was applied.Results: As expected, data analyses revealed that in the IBSR training group chronic stress and trait anxiety statistically significantly decreased over the course of three months whereas in the matched control group, the levels of chronic stress and trait anxiety did not statistically significantly change.Conclusions: IBSR seems to effectively reduce trait anxiety and chronic stress in a non-clinical sample.
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Landau C, Lev-Ari S, Cohen-Mansfield J, Tillinger E, Geva R, Tarrasch R, Mitnik I, Friedman E. Randomized controlled trial of Inquiry-Based Stress Reduction (IBSR) technique forBRCA1/2mutation carriers. Psychooncology 2014; 24:726-31. [DOI: 10.1002/pon.3703] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Revised: 09/11/2014] [Accepted: 09/14/2014] [Indexed: 11/10/2022]
Affiliation(s)
- Carla Landau
- Institute of Oncology, Tel-Aviv Medical Center; Tel Aviv Israel
- Department of health promotion, Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Shahar Lev-Ari
- Institute of Oncology, Tel-Aviv Medical Center; Tel Aviv Israel
- Department of health promotion, Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Jiska Cohen-Mansfield
- Department of health promotion, Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Efrat Tillinger
- Department of health promotion, Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Ravit Geva
- Institute of Oncology, Tel-Aviv Medical Center; Tel Aviv Israel
| | - Ricardo Tarrasch
- School of Education, Tel Aviv University; Sagol School of Neuroscience; Tel Aviv University; Tel Aviv Israel
| | - Inbal Mitnik
- Department of health promotion, Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Eitan Friedman
- The Susanne Levy Gertner Oncogenetics Unit; Chaim Sheba Medical Center; Tel-Hashomer Israel
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