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Norweg A, Hofferber B, Maguire S, Oh C, Raveis VH, Simon NM. Breathing on the mind: Treating dyspnea and anxiety symptoms with biofeedback in chronic lung disease - A qualitative analysis. Respir Med 2024; 221:107505. [PMID: 38141864 PMCID: PMC10897906 DOI: 10.1016/j.rmed.2023.107505] [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: 09/23/2023] [Revised: 11/26/2023] [Accepted: 12/17/2023] [Indexed: 12/25/2023]
Abstract
RATIONALE Chronic obstructive pulmonary disease (COPD) is characterized by dysfunctional breathing patterns that contribute to impaired lung function and symptoms of dyspnea, anxiety, and abnormal carbon dioxide (CO2) levels. OBJECTIVE The study objective was to measure the acceptability of a new mind-body intervention we developed called Capnography-Assisted, Learned Monitored (CALM) Breathing, implemented before pulmonary rehabilitation. METHODS CALM Breathing is a 4-week (8-session) intervention designed to treat dyspnea and anxiety in adults with COPD by targeting dysfunctional breathing behaviors (guided by end-tidal CO2 levels). CALM Breathing consists of ten core breathing exercises, CO2 biofeedback, and motivational interviewing. Using qualitative methods and semi-structured interviews immediately post-intervention, we evaluated the acceptability and participation process of CALM Breathing. Themes were identified using constant comparative analysis. RESULTS Sixteen participants were interviewed after receiving CALM Breathing. Three main themes of CALM Breathing were identified: (1) Process of learning self-regulated breathing, (2) Mechanisms of a mind-body intervention, (3) Clinical and implementation outcomes. CONCLUSIONS Positive themes supported the acceptability of CALM Breathing and described participants' process of learning more self-regulated breathing to manage their dyspnea and anxiety. Positive signals from qualitative participant feedback provided support for CALM Breathing as an intervention for COPD, but larger scale efficacy trials are needed.
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Affiliation(s)
- Anna Norweg
- Department of Rehabilitation and Regenerative Medicine, Columbia University Irving Medical Center, New York, NY, USA.
| | - Brittany Hofferber
- Department of Rehabilitation and Regenerative Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Sophia Maguire
- Department of Rehabilitation and Regenerative Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Cheongeun Oh
- Department of Population Health (Biostatistics), New York University Grossman School of Medicine, New York, NY, USA
| | - Victoria H Raveis
- Department of Cariology and Comprehensive Care, College of Dentistry, New York University, New York, NY, USA
| | - Naomi M Simon
- Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA
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2
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Beaumont M, Latiers AC, Prieur G. [The role of the physiotherapist in the assessment and management of dyspnea]. Rev Mal Respir 2023; 40:169-187. [PMID: 36682956 DOI: 10.1016/j.rmr.2022.12.016] [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: 12/01/2021] [Accepted: 12/20/2022] [Indexed: 01/21/2023]
Abstract
The role of the physiotherapist in the assessment and management of dyspnea. Dyspnea is the most common symptom in cardio-respiratory diseases. Recently improved comprehension of dyspnea mechanisms have underlined the need for three-faceted assessment. The three key aspects correspond to the "breathing, thinking, functioning" clinical model, which proposes a multidimensional - respiratory, emotional and functional - approach. Before initiating treatment, it is essential for several reasons to assess each specific case, determining the type of dyspnea affecting the patient, appraising the impact of shortness of breath, and estimating the effectiveness of the treatment applied. The physiotherapist has a major role to assume in the care of dyspneic patients, not only in assessment followed by treatment but also as a major collaborator in a multidisciplinary team, especially with regard to pulmonary rehabilitation. The aim of this review is to inventory the existing assessment tools and the possible physiotherapies for dyspnea, using a holistic approach designed to facilitate the choice of techniques and to improve quality of care by fully addressing the patient's needs.
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Affiliation(s)
- M Beaumont
- Service de réadaptation respiratoire, Centre Hospitalier des Pays de Morlaix, Morlaix, France; Inserm, Univ Brest, CHRU Brest, UMR 1304, GETBO, Brest, France.
| | - A C Latiers
- Service ORL, Stomatologie et Soins Continus, Cliniques universitaires Saint-Luc, 1200 Brussels, Belgique
| | - G Prieur
- Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Pneumologie, ORL & Dermatologie, Groupe de Recherche en Kinésithérapie Respiratoire, Université Catholique de Louvain, 1200 Brussels, Belgique; Université de Normandie, UNIROUEN, EA3830-GRHV, 76000 Rouen, France; Groupe Hospitalier du Havre, Service de pneumologie et de réadaptation respiratoire, avenue Pierre Mendes France, 76290 Montivilliers, France; Institut de Recherche et Innovation en Biomédecine (IRIB), 76000 Rouen, France
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3
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Wan X, Huang H, Liang D, Jia RY, Chen CR. Effect of remote mindfulness-based interventions on symptoms of anxiety and depression in patients with chronic obstructive pulmonary disease: a protocol for systematic review and meta-analysis. BMJ Open 2022; 12:e055369. [PMID: 35190437 PMCID: PMC8889443 DOI: 10.1136/bmjopen-2021-055369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The incidence of chronic obstructive pulmonary disease (COPD) is high worldwide, and patients with COPD commonly suffer from mood disorders, such as symptoms of anxiety and depression. However, it is difficult to communicate with patients face to face to solve these psychological problems in the case of the fluctuations in symptoms of COPD and COVID-19 prevalence, which may lead to the fact that patients with COPD are more likely to suffer exacerbations, frequent readmissions and worse survival. Mindfulness-based interventions are a stress-reducing therapy with mindfulness at its core. Remote mindfulness-based interventions combine the advantages of high availability, accessibility, low cost and anonymity and can solve the barriers to access that many patients face when attending face-to-face programmes. Therefore, remote mindfulness-based interventions may be an effective way to improve the mental health of patients with COPD. METHODS AND ANALYSIS We will search PubMed, Embase, Cochrane Library, CNKI, PsycNET, MEDLINE, Psychology & Behavioral Sciences Collection and Web of Science to select eligible studies that were published. The eligible studies will be screened, extracted and then the methodological quality will be evaluated independently by two reviewers. Review manager software V.5.3 software and Stata V.14.0 software will be used for meta-analysis. ETHICS AND DISSEMINATION Ethical approval is not required for a systematic review protocol. Findings of the proposed systematic review will be disseminated through conference presentations and publication in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42021265286.
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Affiliation(s)
- Xiao Wan
- Insitute of Nursing and Health, Henan University, Kaifeng, Henan, China
| | - Haitao Huang
- Insitute of Nursing and Health, Henan University, Kaifeng, Henan, China
| | - Dandan Liang
- Insitute of Nursing and Health, Henan University, Kaifeng, Henan, China
| | - Rui-Ying Jia
- Insitute of Nursing and Health, Henan University, Kaifeng, Henan, China
| | - Chao-Ran Chen
- Insitute of Nursing and Health, Henan University, Kaifeng, Henan, China
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4
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Leyro TM, Versella MV, Yang MJ, Brinkman HR, Hoyt DL, Lehrer P. Respiratory therapy for the treatment of anxiety: Meta-analytic review and regression. Clin Psychol Rev 2021; 84:101980. [PMID: 33540222 PMCID: PMC8302658 DOI: 10.1016/j.cpr.2021.101980] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 11/30/2020] [Accepted: 01/19/2021] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Respiratory abnormalities are a hallmark of anxiety symptomatology and may serve as clinically useful modifiers for alleviating anxiety symptoms. However, gold-standard anxiety treatments (e.g., cognitive-behavioral interventions) often do not directly address respiratory components despite their theoretical utility and clinical accessibility. This review examined the clinical effectiveness of respiratory interventions, interventions that directly target respiration abnormalities and processes, in treating trait anxiety symptoms. METHODS The final analysis included 40 randomized controlled trials including at least one measure of trait anxiety, a respiratory-focused intervention group, and a non-respiratory control-group (active or inactive treatment). Overall effects of respiratory focused interventions were examined, as well as the effect of hypothesized moderators. RESULTS Respiratory component interventions yielded significantly greater improvements (moderate to large effect) in anxiety symptoms than controls, with the stronger effects observed in comparison to inactive, rather than active, control conditions. Significant heterogeneity in findings suggests that variability in intervention design, population, and control comparison may obfuscate interpretation of findings. CONCLUSIONS Evidence supports the clinical utility of respiratory interventions as either an independent anxiety treatment, or as an adjunct to other interventions. Clinical and research implications of findings along with recommendations for ongoing investigations in this domain are discussed.
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Affiliation(s)
- Teresa M Leyro
- Department of Psychology, Rutgers, The State University of New Jersey, United States.
| | - Mark V Versella
- Department of Psychology, Rutgers, The State University of New Jersey, United States
| | - Min-Jeong Yang
- Department of Psychology, Rutgers, The State University of New Jersey, United States; Department of Health Outcomes and Behavior, Moffitt Cancer Center, United States
| | - Hannah R Brinkman
- Department of Psychology, Rutgers, The State University of New Jersey, United States
| | - Danielle L Hoyt
- Department of Psychology, Rutgers, The State University of New Jersey, United States
| | - Paul Lehrer
- Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, United States
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5
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Oman D, Bormann JE, Kane JJ. Mantram Repetition as a Portable Mindfulness Practice: Applications During the COVID-19 Pandemic. Mindfulness (N Y) 2020; 13:1418-1429. [PMID: 33224309 PMCID: PMC7667218 DOI: 10.1007/s12671-020-01545-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/27/2020] [Indexed: 12/12/2022]
Abstract
Objective Mantram or holy name repetition has long been practiced in every major religious tradition. Repetition of a mantram as a mindfulness practice is helpful for stress management and resilience building. The objective of this article is to provide an overview of the key features of mantram and the Mantram Repetition Program (MRP) developed in the US Veterans Healthcare System, the evidence base for the MRP, and its applications. Methods MRP practices are portable and do not require an extended or regularized period of sitting, in contrast to most methods of meditation. Core functions of MRP practices include focus shifting, frame activation, and fostering of mindfulness. We review scientific research, including multiple randomized trials, that has investigated the MRP. Results Research on the MRP has documented reductions in posttraumatic stress symptoms, insomnia, hyperarousal, and depression, as well as enhancement of quality of life, self-efficacy, and mindfulness. Mantram repetition may possess comparative advantages for managing symptoms of various mental health conditions, including posttraumatic stress disorder, HIV/AIDS, cancer, and chronic diseases. Conclusions MRP practices can be integrated into daily routines to manage stress and improve coping, safety, efficacy, calmness, and resilience. The inclusion of mantram repetition alongside conventional mindfulness-based practices for stress management will improve their cultural and religious inclusiveness, enabling societies and organizations to build greater collective resilience. Mantram repetition can be readily used in the COVID-19 pandemic, focusing on healthcare workers, patients, and the public.
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Affiliation(s)
- Doug Oman
- School of Public Health, University of California, 2121 Berkeley Way, Room #5302, Berkeley, CA 94720-7360 USA
| | - Jill E. Bormann
- Hahn School of Nursing and Health Sciences/Beyster Institute of Nursing Research, University of San Diego, 5998 Alcala Park, San Diego, CA 92110-2492 USA
| | - Jim J. Kane
- Department of Education, Development & Research, Hillcrest Medical Center, University of California, San Diego, 402 Dickinson St. Mail Code 8929, San Diego, CA 92103 USA
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6
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Hsieh CC, Ho CC, Lin ZZ, Yu CJ, Jow GM, Huang FY, Shih JY, Hsiao FH. Trait mindfulness and depressive symptoms in non-small cell lung cancer patients: the mediating roles of quality of life and meaning in life. Psychol Health 2020; 36:1102-1114. [PMID: 32998574 DOI: 10.1080/08870446.2020.1825713] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The present study examined the potential mediating influences of meaning in life and quality of life in the relationship of trait mindfulness and depressive symptoms in lung cancer patients. Design: We adopted a cross-sectional design studying a sample of patients with non-small cell lung cancer, aged 20-65 years, and receiving cancer treatments or follow-up care. Main Outcome Measures: The outcome measures included Beck Depression Inventory-II, European Organisation for Research and Treatment of Cancer Core Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and lung cancer specific complementary measure (EORTC QLQ-LC13), Five Facet Mindfulness Questionnaire, and the meaning in life questionnaire. Results: Among 116 lung cancer patients, 26.72% of them had clinically significant depressive symptoms. The presence of meaning, quality of life (QOL) functioning and symptom distress mediated the relationship of trait mindfulness and depressive symptoms. Multiple mediation analyses found that the presence of meaning in life was the main mediator. Conclusion: The reductions of depressive symptoms might be related to trait mindfulness enhancing lung cancer patients' perceptions of meaning in life. A mindfulness program has the potential to improve depressive symptoms in people with lung cancer.
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Affiliation(s)
- Chia-Chen Hsieh
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chao-Chi Ho
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Zhong-Zhe Lin
- Department of Medical Oncology, National Taiwan University Cancer Center, Taipei, Taiwan
| | - Chong-Jen Yu
- College of Medicine, National Taiwan University, Taipei, Taiwan.,BioMedical Park Branch, National Taiwan University Hospital, , Hsinchu, Taiwan
| | - Guey-Mei Jow
- School of Medicine, Fu-Jen Catholic University, Taipei, Taiwan
| | - Feng-Ying Huang
- Department of Education, National Taipei University of Education, Taipei, Taiwan
| | - Jin-Yuan Shih
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Fei-Hsiu Hsiao
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.,Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
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7
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Lack S, Brown R, Kinser PA. An Integrative Review of Yoga and Mindfulness-Based Approaches for Children and Adolescents with Asthma. J Pediatr Nurs 2020; 52:76-81. [PMID: 32213455 DOI: 10.1016/j.pedn.2020.03.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 03/10/2020] [Accepted: 03/13/2020] [Indexed: 01/08/2023]
Abstract
PROBLEM Asthma affects almost 15% of children in the United States. Despite the availability of treatments and educational methods, children with asthma continue to report an impaired quality of life, including symptoms of anxiety and inability to participate in physical activity. As complementary health approaches are becoming more popular and show promise in the management of many chronic diseases, the purpose of this integrative review is to examine the state of the science regarding popular complementary health approaches- yoga and mindfulness- for children and adolescents with asthma. ELIGIBILITY CRITERIA A comprehensive search of five databases for peer reviewed articles was performed to identify experimental and non-experimental studies. The search for each database was performed from the inception of each to January 2020 and limited to the English language. The search included terminology that addressed the concepts of "asthma", "yoga" and "mindfulness". SAMPLE A total of eleven articles met the criteria for review from the years 1991 to 2019. RESULTS Nine publications focused on the use of yoga in children and adolescents with asthma and two publications focused on mindfulness in adolescents with asthma. CONCLUSIONS Interventions involving either mindfulness or yoga may be effective in reducing stress and anxiety and improving quality of life and lung function in this population. IMPLICATIONS Mindfulness intervention studies in the pediatric and adolescent asthma population are warranted as are additional studies that include the use of yoga with skills in mindfulness in order to evaluate their physiological and psychological effects.
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Affiliation(s)
- Sharon Lack
- Virginia Commonwealth University School of Nursing, United States of America.
| | - Roy Brown
- Virginia Commonwealth University School of Nursing, United States of America
| | - Patricia A Kinser
- Virginia Commonwealth University School of Nursing, United States of America
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8
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Tian L, Zhang Y, Li L, Wu Y, Li Y. The efficacy of mindfulness-based interventions for patients with COPD: a systematic review and meta-analysis protocol. BMJ Open 2019; 9:e026061. [PMID: 31142522 PMCID: PMC6549636 DOI: 10.1136/bmjopen-2018-026061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 02/23/2019] [Accepted: 03/01/2019] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Chronic obstructive pulmonary disease (COPD) is a common chronic respiratory disease. It has adverse effects on patients' physical health, mental well-being and quality of life. The purpose of mindfulness-based interventions (MBIs) is to raise non-judgemental awareness and attention to current internal and external experiences. This means the attention is shifted from perceived and involuntary inner activities to current experience, keeping more curious, open and accepting attitudes towards current experience. Although some studies on the intervention effect of MBIs in patients with COPD have been conducted, the results are controversial, especially on dyspnoea, level of mindfulness and quality of life. Therefore, a systematic review of MBIs in patients with COPD is required to provide available evidence for further study. METHODS AND ANALYSIS In this study, different studies from various databases will be involved. Randomised controlled trials(RCTs)/quantitative studies, qualitative studies and case studies on the effect of MBIs in patients with COPD aged over 18 years will be included. We will search the literature in the databases of PubMed, Excepta Medica Base (EMBASE), Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Cochrane Library, PsycINFO and China National Knowledge Infrastructure(CNKI). The primary outcomes will include efficacy of MBIs for patients with COPD in terms of dyspnoea, depression and anxiety. The secondary outcomes will include efficacy of MBIs in terms of quality of life, mindful awareness, 6-minute walk test(6MWT) and nutritional risk index. Data extraction will be conducted by two researchers independently, and risk of bias of the meta-analysis will be evaluated based on the Cochrane Handbook for Systematic Reviews of Interventions. All data analysis will be conducted by data statistics software Review Manager V.5.3. and Stata V.12.0. ETHICS AND DISSEMINATION Since this study is a systematic review, the findings are based on the published evidence. Therefore, examination and agreement by the ethics committee are not required in this study. We intend to publish the study results in a journal or conference presentations. PROSPERO REGISTRATION NUMBER CRD42018102323.
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Affiliation(s)
- Lingyun Tian
- Xiangya Nursing School, Central South University, Changsha, China
- School of Nursing, Anhui University of Chinese Medicine, Hefei, China
| | - Ying Zhang
- Infection Control Centre, Xiangya Hospital, Central South University, Changsha, China
| | - Li Li
- Department of Nursing, Xiangya Hospital, Central South University, Changsha, China
| | - Ying Wu
- Department of Burn and Reconstruction Surgery, Xiangya Hospital, Central South University, Changsha, China
| | - Yinglan Li
- Department of Nursing, Xiangya Hospital, Central South University, Changsha, China
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9
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Slatore CG, Falvo MJ, Nugent S, Carlson K. Afghanistan and Iraq War Veterans: Mental Health Diagnoses are Associated with Respiratory Disease Diagnoses. Mil Med 2019; 183:e249-e257. [PMID: 29420832 DOI: 10.1093/milmed/usx108] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 11/10/2017] [Indexed: 11/13/2022] Open
Abstract
Introduction Many veterans of the wars in Afghanistan and Iraq have concomitant respiratory conditions and mental health conditions. We wanted to evaluate the association of mental health diagnoses with respiratory disease diagnoses among post-deployment veterans. Methods We conducted a retrospective cohort study of all Afghanistan and Iraq War veterans who were discharged from the military or otherwise became eligible to receive Veterans Health Administration services. The primary exposure was receipt of a mental health diagnosis and the primary outcome was receipt of a respiratory diagnosis as recorded in the electronic health record. We used multivariable adjusted logistic regression to measure the associations of mental health diagnoses with respiratory diagnoses and conducted several analyses exploring the timing of the diagnoses. Results Among 182,338 post-deployment veterans, 14% were diagnosed with a respiratory condition, 77% of whom had a concomitant mental health diagnosis. The incidence rates were 5,363/100,000 person-years (p-y), 587/100,000 p-y, 1,450/100,000 p-y, and 233/100,000 p-y for any respiratory disease diagnosis, bronchitis, asthma, and chronic obstructive lung disease diagnoses, respectively, after the date of first Veterans Health Administration utilization. Any mental health diagnosis was associated with increased odds for any respiratory diagnosis (adjusted odds ratio 1.41, 95% confidence interval 1.37-1.46). The association of mental health diagnoses and subsequent respiratory disease diagnoses was stronger and more consistent than the converse. Conclusion Many Afghanistan and Iraq War veterans are diagnosed with both respiratory and mental illnesses. Comprehensive plans that include care coordination with mental health professionals and treatments for mental illnesses may be important for many veterans with respiratory diseases.
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Affiliation(s)
- Christopher G Slatore
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, (R&D 66) 3710 SW US Veterans Hospital Road, Portland, OR 97239.,Section of Pulmonary & Critical Care Medicine, VA Portland Health Care System, 3710 SW U.S. Veterans Hospital Road, Portland, OR 97239.,Division of Pulmonary and Critical Care Medicine, Department of Medicine, Oregon Health & Science University, OHSU Division of Pulmonary and Critical Care Medicine, 3181 SW Sam Jackson Park Rd, Mail Code UHN6, Portland, OR 97239-3098
| | - Michael J Falvo
- Department of Veterans Affairs, War Related Illness and Injury Study Center, Veterans Affairs New Jersey Health Care System, 385 Tremont Ave, Mail Stop 129, East Orange, NJ 07018-1095.,Rutgers Biomedical and Health Sciences, New Jersey Medical School, The State University of New Jersey, Stanley S. Bergen Building, 65 Bergen Street, Newark, NJ 07103
| | - Shannon Nugent
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, (R&D 66) 3710 SW US Veterans Hospital Road, Portland, OR 97239
| | - Kathleen Carlson
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, (R&D 66) 3710 SW US Veterans Hospital Road, Portland, OR 97239.,School of Public Health, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, MC: GH230, Portland, OR 97239
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10
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Hilton LG, Marshall NJ, Motala A, Taylor SL, Miake-Lye IM, Baxi S, Shanman RM, Solloway MR, Beroesand JM, Hempel S. Mindfulness meditation for workplace wellness: An evidence map. Work 2019; 63:205-218. [PMID: 31156202 PMCID: PMC6598008 DOI: 10.3233/wor-192922] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 12/14/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Mindfulness interventions aim to foster greater attention and awareness of present moment experiences. Uptake of mindfulness programs in the workplace has grown as organizations look to support employee health, wellbeing, and performance. OBJECTIVE In support of evidence-based decision making in workplace contexts, we created an evidence map summarizing physical and mental health, cognitive, affective, and interpersonal outcomes from systematic reviews of randomized controlled trials (RCTs) of mindfulness interventions. METHODS We searched nine electronic databases to July 2017, dually-screened all reviews, and consulted topic experts to identify systematic reviews on mindfulness interventions. The distribution of evidence is presented as an evidence map in a bubble plot. RESULTS In total, 175 systematic reviews met inclusion criteria. Reviews included a variety of mindfulness-based interventions. The largest review included 109 randomized controlled trials. The majority of these addressed general health, psychological conditions, chronic illness, pain, and substance use. Twenty-six systematic reviews assessed studies conducted in workplace settings and with healthcare professionals, educators, and caregivers. The evidence map shows the prevalence of research by the primary area of focus. An outline of promising applications of mindfulness interventions is included. CONCLUSIONS The evidence map provides an overview of existing mindfulness research. It shows the body of available evidence to inform policy and organizational decision-making supporting employee wellbeing in work contexts.
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Affiliation(s)
- Lara G. Hilton
- Evidence-Based Practice Center (EPC), RAND Corporation, Santa Monica, CA, USA
- Deloitte Consulting LLP, Los Angeles, CA, USA
| | - Nell J. Marshall
- Evidence-Based Synthesis Program (ESP) Center, West Los Angeles VA Medical Center, Los Angeles, CA, USA
- VA Palo Alto Healthcare System, Palo Alto, CA, USA
| | - Aneesa Motala
- Evidence-Based Practice Center (EPC), RAND Corporation, Santa Monica, CA, USA
| | - Stephanie L. Taylor
- VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Department of Health Policy, UCLA, Los Angeles, CA, USA
| | - Isomi M. Miake-Lye
- Evidence-Based Synthesis Program (ESP) Center, West Los Angeles VA Medical Center, Los Angeles, CA, USA
| | - Sangita Baxi
- Evidence-Based Practice Center (EPC), RAND Corporation, Santa Monica, CA, USA
| | - Roberta M. Shanman
- Evidence-Based Practice Center (EPC), RAND Corporation, Santa Monica, CA, USA
| | - Michele R. Solloway
- Child and Adolescent Health Measurement Initiative, Department of Population, Family and Reproductive Health, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Jessica M. Beroesand
- Evidence-Based Synthesis Program (ESP) Center, West Los Angeles VA Medical Center, Los Angeles, CA, USA
| | - Susanne Hempel
- Evidence-Based Practice Center (EPC), RAND Corporation, Santa Monica, CA, USA
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11
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Malpass A, Feder G, Dodd JW. Understanding changes in dyspnoea perception in obstructive lung disease after mindfulness training. BMJ Open Respir Res 2018; 5:e000309. [PMID: 29955365 PMCID: PMC6018883 DOI: 10.1136/bmjresp-2018-000309] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Indexed: 12/03/2022] Open
Abstract
Introduction Dyspnoea has been defined as a ‘subjective experience of breathing discomfort that consists of qualitatively distinct sensations that vary in intensity’. However, the majority of available dyspnoea measures treat it as a single entity and rely on quantitative methodology. We propose that qualitative research can enhance our understanding of dyspnoea, in particular, how perception varies so much among patients with similar disease states. In this paper, we focus on how a specific type of inner attention—mindfulness—may alter perceptions of dyspnoea. The aim is to characterise mindfulness attention, which impacts on perceptions of dyspnoea and relate these to the multidimensional model of dyspnoea. We explore how an individual can change their perception and therefore relationship to similar disease states. Method 22 patients with asthma or chronic obstructive pulmonary disease were recruited from primary and secondary care to an 8-week course in mindfulness-based cognitive therapy (MBCT). 12 patients took part in an in-depth qualitative interview 2 months after completing the MBCT course. Data were recorded, transcribed and then analysed using a framework approach, drawing on components of the multidimensional model of dyspnoea (multidimensional dyspnoea profile, MDP). Results We found that MBCT training involves developing three types of mindful attention (broad attention, informative attention and re-directive attention), which impact on perceptions of the sensory dimension of dyspnoea. MBCT appears to target affective and sensory perceptions articulated in the MDP model. Conclusion More research is needed into how mindfulness-based interventions may mediate the relationship between affective experience and the sensory perception of dyspnoea symptoms.
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Affiliation(s)
- Alice Malpass
- Centre for Academic Primary Care (CAPC), Bristol Medical School, University of Bristol, Bristol, UK
| | - Gene Feder
- Centre for Academic Primary Care (CAPC), Bristol Medical School, University of Bristol, Bristol, UK
| | - James W Dodd
- Academic Respiratory Unit, University of Bristol, Southmead Hospital, Bristol, UK.,Academic Respiratory Medicine, University of Bristol, Bristol, UK
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12
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Paudyal P, Jones C, Grindey C, Dawood R, Smith H. Meditation for asthma: Systematic review and meta-analysis. J Asthma 2017; 55:771-778. [PMID: 28853958 DOI: 10.1080/02770903.2017.1365887] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To conduct a comprehensive review and meta-analysis of the effectiveness of meditation on a variety of asthma outcomes. METHODS We searched MEDLINE, EMBASE, CINAHL, PsycINFO and AMED in June 2016 to identify randomized controlled trials (RCTs) investigating the effectiveness of meditation in adults with asthma. No restriction was put on language or year of publication. Study quality was assessed using The Cochrane Risk of Bias Assessment Tool. Meta-analysis was carried out using RevMan 5.3. RESULTS Four RCTs involving 201 patients met the inclusion criteria. Quality of studies was inconsistent with only one study reporting adequate allocation concealment. Disease-specific quality of life was assessed in two trials; a pooled result involving 62 intervention and 65 control participants indicated a significant improvement in quality of life in the meditation group compared to the control group (SMD 0.40, 95% CI 0.05-0.76). A pooled result from all four studies indicated the uncertain effect of meditation in forced expiratory volume in 1 s (FEV1) (SMD -0.67, 95% CI -2.17 to 0.82). Results from the individual trials suggest that meditation may be helpful in reducing perceived stress and the use of short-term rescue medication. CONCLUSION Our review suggests that there is some evidence that meditation is beneficial in improving quality of life in asthma patients. As two out of four studies in our review were of poor quality, further trials with better methodological quality are needed to support or refute this finding.
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Affiliation(s)
- Priyamvada Paudyal
- a Department of Primary Care and Public Health , Brighton and Sussex Medical School , Brighton , United Kingdom
| | - Christina Jones
- b Department of Clinical Medicine , Brighton and Sussex Medical School , Brighton , United Kingdom
| | - Caroline Grindey
- a Department of Primary Care and Public Health , Brighton and Sussex Medical School , Brighton , United Kingdom
| | - Rusha Dawood
- a Department of Primary Care and Public Health , Brighton and Sussex Medical School , Brighton , United Kingdom
| | - Helen Smith
- c Family Medicine and Primary Care , Lee Kong Chian School of Medicine , Singapore , Singapore
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Chiesa A, Fazia T, Bernardinelli L, Morandi G. Citation patterns and trends of systematic reviews about mindfulness. Complement Ther Clin Pract 2017; 28:26-37. [PMID: 28779934 DOI: 10.1016/j.ctcp.2017.04.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 04/22/2017] [Accepted: 04/27/2017] [Indexed: 12/21/2022]
Abstract
OBJECTIVES We performed a citation analysis of the literature about mindfulness aimed at describing the most significant topics and the impact of more relevant papers. METHODS We classified 128 systematic reviews about mindfulness-based intervention retrieved in Scopus according to their object, the population included and the type of mindfulness proposed. The citation counting was reported. The cumulative citation numbers per chronological years and article life were analyzed thorough a linear regression model. RESULTS 1) We observed a general increase in the number of reviews published from 2003 to 2016; 2) two reviews collected the 33% of the overall citations; 3) citation counting for clinical and mixed population collected the 90% of total citations; 4) clinical reviews had higher cumulative citation per publication/year growth. CONCLUSIONS As mindfulness research advances, higher attention should be given to the mechanisms by which mindfulness interventions work so as to provide fruitful insights for future research.
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Affiliation(s)
- Alberto Chiesa
- Istituto Mente e Corpo, Bologna, Italy; Associazione di Psicologia Cognitiva - Scuola di Psicoterapia Cognitiva, Roma, Italy
| | - Teresa Fazia
- Department of Brain and Behavioral Science, Medical and Genomic Statistics Unit, University of Pavia, Italy
| | - Luisa Bernardinelli
- Department of Brain and Behavioral Science, Medical and Genomic Statistics Unit, University of Pavia, Italy
| | - Gabriella Morandi
- Department of Brain and Behavioral Science, Medical and Genomic Statistics Unit, University of Pavia, Italy.
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Harrison SL, Lee A, Goldstein RS, Brooks D. Perspectives of healthcare professionals and patients on the application of mindfulness in individuals with chronic obstructive pulmonary disease. PATIENT EDUCATION AND COUNSELING 2017; 100:337-342. [PMID: 27567496 DOI: 10.1016/j.pec.2016.08.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 08/08/2016] [Accepted: 08/19/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To explore the views of healthcare professionals (HCPs) and patients towards mindfulness for individuals with COPD. METHODS A qualitative study design informed by and analyzed using deductive thematic analysis. Twenty HCPs, with at least one year's clinical experience in COPD management and 19 individuals with moderate to severe COPD participated in semi-structured interviews. RESULTS Analysis revealed seven themes. 1. Mindfulness is difficult to articulate and separate from relaxation. 2. Mindfulness has a role in disease management. 3. Mindfulness therapy should be optional. 4. Preferred techniques include; breathing meditation, music and body scan. 5. Mindfulness should be delivered by knowledgeable, enthusiastic and compassionate trainers. 6. Preferred mode of delivery is shorter sessions delivered alongside pulmonary rehabilitation, with refresher courses 7. Efficacy should be assessed using psychological outcome measures and qualitative methodologies. CONCLUSIONS Mindfulness appears to be an attractive therapy for individuals with COPD. An understanding of the perspectives of HCPs and patients should inform the delivery of such programs. PRACTICAL IMPLICATION Individuals with COPD were comfortable using breathing to reduce anxiety. Stigma and negative preconceptions were considered barriers to participation. Short sessions delivered by experienced trainers were preferred. A combination of methodologies should be used to examine effectiveness.
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Affiliation(s)
- Samantha L Harrison
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, Ontario, Canada; Health and Social Care Institute, School of Health and Social Care, Teesside University, Middlesbrough, UK.
| | - Annemarie Lee
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, Ontario, Canada
| | - Roger S Goldstein
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, ON, Canada; Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Dina Brooks
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, Ontario, Canada; Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
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Hyland ME, Halpin DM, Blake S, Seamark C, Pinnuck M, Ward D, Whalley B, Greaves CJ, Hawkins AL, Seamark D. Preference for different relaxation techniques by COPD patients: comparison between six techniques. Int J Chron Obstruct Pulmon Dis 2016; 11:2315-2319. [PMID: 27695317 PMCID: PMC5034903 DOI: 10.2147/copd.s113108] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background A review of the effectiveness of relaxation techniques for chronic obstructive pulmonary disease patients has shown inconsistent results, but studies have varied in terms of technique and outcome measures. Aim To determine patient preference for different relaxation techniques. Methods Chronic obstructive pulmonary disease patients were presented with six techniques via a DVD and asked to rate the techniques in terms of effectiveness, rank in order of likely use, and comment. Results Patients differed in the technique preferred and reason for that preference, but the most commonly preferred technique both for effectiveness and ease of use was “thinking of a nice place” followed by progressive relaxation and counting. Familiarity and ease of activity were commonly given reasons for preference. Conclusion Rather than providing patients with a single technique that they might find difficult to implement, these results suggest that it would be better to give a choice. “Thinking of a nice place” is a popular but under-investigated technique.
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Affiliation(s)
| | - David Mg Halpin
- Department of Respiratory Medicine, Royal Devon and Exeter Hospital, Exeter
| | | | | | | | | | - Ben Whalley
- School of Psychology, University of Plymouth, Plymouth
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