Positive psychological interventions for neurological disorders: A systematic review

The Listening Guide: Illustrating an underused voice-centred methodology to foreground underrepresented research populations

AIM

To highlight the value of utilizing the Listening Guide methodology for nursing research and provide an exemplar applying this methodology to explore a novel concept in an underrepresented group-inner strength in persons newly diagnosed with mild cognitive impairment along with their care partners.

DESIGN

Methodology discussion paper.

METHODS

The exemplar study used the Listening Guide methods for data elicitation and analysis. Methods included adaptations for the study population and novice qualitative researchers.

RESULTS

The Listening Guide methodology with adaptations enabled the research team to centre the voices of persons living with mild cognitive impairment, highlight an abstract phenomenon and attend to the influences of the sociopolitical context. Further, this methodology helped address common challenges emerging qualitative researchers encounter, including understanding methods of application, engaging reflexively and immersing in the data.

CONCLUSION

The Listening Guide is a voice-centred qualitative methodology that is well suited to foreground the experiences of groups underrepresented in research and explore emerging phenomena.

IMPLICATIONS FOR NURSING

Nurses are central to striving for health equity. The Listening Guide methodology offers a valuable and accessible research tool to understand the experiences and needs of underrepresented groups and shape healthcare in response.

IMPACT

The Listening Guide methodology can be broadly applied to research with persons with mild cognitive impairment, and other underrepresented groups, to explore other phenomena beyond inner strength and move the science forward in representing the perspectives of groups underrepresented by research.

PATIENT OR PUBLIC CONTRIBUTION

Persons living with cognitive impairment and their care partners participated in study conceptualization, interview guide development, methods development and dissemination plans.

Effects of occupational health promotion interventions on health-related outcomes among employees of small businesses and self-employed individuals: A systematic review

BACKGROUND

Compared to workers of larger companies it is less clear what health promoting interventions might be beneficial for employees of small businesses and self-employed individuals.

OBJECTIVE

Our aim was to critically appraise trials investigating health promotion programs among small business workers and self-employed individuals, by means of a systematic review.

METHODS

We conducted a search of primary studies using MEDLINE, Web of Science, LIVIVO and the Cochrane library. Our assessment followed the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions and PRISMA.

RESULTS

We identified six trials including 5,854 participants from Asia, North America and Australia. Most were of moderate methodological quality, only one was of low quality. Some of the supervised psycho-educational lifestyle programs focusing on individual behavior changes showed benefits in terms of stress reduction and increased physical activity levels among small enterprise employees.

CONCLUSIONS

There is a huge knowledge gap on evidence-based health promotion interventions for self-employed and for small business workers, especially in Europe.

A qualitative analysis of virtues and strengths in persons living with early stage dementia informed by the values in action framework

BACKGROUND

Despite evidence that individuals' virtues and character strengths can contribute to a sense of fulfillment, the majority of dementia research focuses on losses and decline. To date, virtues and character strengths in persons living with dementia is an understudied phenomena. This study begins to addresses this gap in the literature.

OBJECTIVES

The objectives of this study were to: (1) examine the expression of virtues and character strengths in persons living with dementia in the early stages; and (2) share implications and recommendations for strengths-based clinical practice and future research.

METHODS

Qualitative data was utilized to examine virtues and character strengths among persons living with dementia. This data was derived from semi-structured interviews with 25 persons living with dementia age 65 or older (average age of 77.88). The interviews were audio recorded with consent, professionally transcribed, audit checked, and subjected to Interpretive Phenomenological analysis which was informed by the Values in Action (VIA) framework.

FINDINGS

Each of the virtues and 24 corresponding character strengths from the VIA framework were observed in this sample. The most frequently observed character strengths were love, spirituality, perseverance, and gratitude.

IMPLICATIONS

Persons with dementia continue to express virtues and character strengths in the context of cognitive and functional changes. Positive strengths-based research and clinical practice should highlight and build upon these individual virtues and character strengths.

Piloting positive psychology resources for caregivers of a child with a genetic developmental and epileptic encephalopathy

Developmental and epileptic encephalopathies (DEEs) are chronic and life-threatening conditions, frequently with a genetic basis and infantile-onset. Caregivers often experience enduring distress adapting to their child's diagnosis and report a deficit of accessible psychological supports. We aimed to pilot a novel, empirically-driven suite of audio-visual positive psychology resources tailored for caregivers of children with a DEE, called 'Finding a Way'.

METHODS

We recruited caregivers through two paediatric hospital databases, and we also shared an invitation to the online questionnaire via genetic epilepsy advocacy organisations. The online questionnaire included a combination of validated, purpose-designed, and open-ended questions to assess the acceptability, relevance, and emotional impact of the resources among caregivers.

RESULTS

167 caregivers from 18 countries reviewed the resources, with 56 caregivers completing over 85% of the evaluation. Caregivers rated the resources as highly acceptable and relevant to their experiences. In both the quantitative and qualitative data, caregivers reported that the resources normalised their emotional experiences and provided helpful suggestions about managing their personal relationships, seeking support and accepting help from others. Frequently reported emotional responses after viewing the resources included feeling "comforted", "hopeful", "connected" and "reassured". Suggestions for improvement included, expanding the suite of resources and embedding the resources with links to specialised psychological services.

CONCLUSION

'Finding a Way' is a novel codesigned suite of audio-visual positive psychology resources tailored for caregivers of children with DEEs. Our results suggest that 'Finding a Way' is acceptable to caregivers and may contribute towards enhanced emotional adaptation and coping.

Neuropsychiatric Treatments for Epilepsy: Nonpharmacological Approaches

Neuropsychiatric conditions are frequently found in patients with epilepsy (PWE). These entities can be as disabling as epilepsy resulting in a significant negative impact on the quality of life of this population if not addressed and treated appropriately. In this article, we provide an overview of non-pharmacological treatments currently available to these patients-and review their effect on mood and anxiety disorders as well as epilepsy. These treatment strategies will allow the practitioner to optimize clinical care during the initial evaluation, which begins with the recognition of the neuropsychiatric condition followed by the appropriate individualized psychotherapeutic approach and/or neuromodulation therapy. To plan a comprehensive treatment for PWE, practitioners must be familiar with these therapeutic tools. Additional clinical research is needed to further create a multidisciplinary team in the assessment and management of neuropsychiatric disorders in PWE.

Acting on Values: A Novel Intervention Enhancing Hedonic and Eudaimonic Well-Being

Individuals increase well-being by acting on their values rather than merely endorsing them. We developed a novel intervention ("Acting on Values," AoV), motivating individuals to initiate values-related behavior over four weeks. Building upon the theory of Basic Human Values, we expected that intervention recipients would increase their hedonic and eudaimonic well-being relative to a control group. We also expected the AoV interventions to cause similar effects as a mindfulness group. 783 volunteers (N = 268 completers) were assigned into three groups: AoV intervention, mindfulness, and a waiting list. Individuals who completed the AoV intervention achieved higher satisfaction with life, positive affect, and eudaimonic well-being, and lower negative affect than the control group. The well-being effects of the AoV intervention did not differ significantly from the mindfulness intervention effects. Our findings suggest that the AoV intervention is an efficacious method of increasing hedonic and eudaimonic well-being. It contributes to the diversity of well-being facilitation methods.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s10902-022-00585-4.

Feasibility and effects of a chair-based yoga program for adults with neurodisability

Purpose: This study focuses on exploring the feasibility and the effects of practicing chair-based yoga for 10 weeks on health-related quality of life (HRQoL) and interoceptive body awareness (BA) in adults with neurodisability and moderate to severe physical dependence.Materials and Methods: A pre- and post-testing control group design was followed. Participants were 34 service users at a rehabilitation center. The intervention group (IG, n = 17, 53% men, mean age of 48.6 ± 11.4 years) took part in the 10-week chair-based yoga program. The control group (CG, n = 17, 53% men, mean age of 53.1 ± 11.0 years) received usual care. The outcome measures were feasibility (recruitment rate, attrition, completion rate, adherence, participation, safety and tolerability), HRQoL (WHOQoL-BREF questionnaire), and BA (the Multidimensional Assessment of Interoceptive Awareness, MAIA). Participants in the IG completed a questionnaire to measure their personal experience of participating in the program.Results and Conclusions: This study provides implications for a 10-week chair-based yoga program as a feasible, well-tolerated, and safe intervention, reinforced by the participants' retrospective judgment. Compared to the CG, the program produced statistically significant improvements over BA, such as subscales of MAIA Noticing (p = .031, Hedges g_s = 0.76), Emotional Awareness (p < .001, Hedges g_s = 1.68), and Trusting (p = .036, Hedges g_s = 0.74), but not HRQoL, for the IG. Chair-based yoga programs could be a rehabilitation strategy in the socio-health care of a varied population with physical mobility impairments leading to wheelchair use.Implications for RehabilitationA 10-week chair-based yoga intervention was shown to be a feasible, well-tolerated, and safe therapy which allowed people of varying abilities to participate equitable.Chair-based yoga can help people with moderate to severe physical dependence due to neurodisability to improve their interoceptive body awareness.Chair-based yoga does not have a significant impact on the health-related quality of life of this sample of participants.

Mindfulness-based intervention to promote psychological wellbeing in people with epilepsy: A randomized controlled trial

BACKGROUND

We investigated the efficacy of mindfulness-based intervention (MBI) in promoting psychological wellbeing in people with epilepsy (PWE) using an assessor-blinded randomized controlled design.

METHODS

A total of 28 PWE were randomly assigned to either intervention (n = 14 cases) or control group (n = 14 controls). The intervention group received a six 2.5-hour weekly MBI, while the control group did not receive any intervention. They were assessed at three timepoints (T0: before intervention, T1: immediately after intervention, and T2: 6 weeks after intervention). Repeated measures of analyses of variance (RM-ANOVAs) were used for inter-group comparisons to determine intervention effect from baseline -to T1 and -to T2 for all outcome measures. The individual changes were calculated using the reliable change index (RCI). Key outcomes included depression (BDI-II), anxiety (BAI), epilepsy-related quality of life (QOLIE-31), satisfaction with life (SWLS), and level of mindfulness (MAAS).

RESULTS

Participants who participated in the MBI showed significant reduction in BDI-II (p = 0.001), significant increases in MAAS (p = 0.027) and QOLIE-31 (p = 0.001) at T1 when compared with the control group. However, BAI and SWLS were not significant. The trend was similar at 6-week follow-up, all outcome measures of MBI remained significant (p < 0.05) except for BAI and SWLS. Beyond the 6-week intervention, RCI analysis showed a significant improvement in levels of mindfulness (45.45% vs. 21.43%, p = 0.009), depression (45.45% vs. 0.00%, p = 0.016), quality of life (45.45% vs. 14.29%, p = 0.017) with MBI, as compared to the no-intervention phase.

CONCLUSION

Mindfulness-based intervention is effective in reducing psychological distress and improving the quality of life in PWE.

The effect of an emotional intelligence component program on happiness in patients with epilepsy

Emotional intelligence is a psychological component that may affect happiness level in patients with epilepsy. Given the high prevalence of depression in patients with epilepsy, as well as the limitations of studies in this regard in Iran, the aim of this study was to investigate the effect of an emotional intelligence component program on happiness in patients with epilepsy.

METHODS

This randomized clinical trial study conducted on 70 patients with epilepsy who were randomly divided into two experimental and control groups of 35 patients. Emotional Intelligence Training Based on Bar-On Combined Model was provided in eight 90-minute sessions for eight weeks. Data were collected using a two-part questionnaire: demographic data and the Oxford Happiness Questionnaire (OHQ).

RESULTS

The mean age of the subjects was 33.3 ± 10.4 years in the intervention group and 34.4 ± 9.3 years in the control group. The independent t-test results showed no significant difference between the two groups before the intervention (p = 0.195). The Mann-Whitney test results showed a significant difference between the two groups after emotional intelligence training (p < 0.001).

CONCLUSION

Overall, the findings of this study showed that emotional intelligence training led to improvement of happiness in patients with epilepsy. According to the results of the study, it is suggested that training based on emotional intelligence components be used as an approach to improve happiness level in patients with epilepsy.

Recent Advances in Cognitive Behavioral Therapy For Digestive Disorders and the Role of Applied Positive Psychology Across the Spectrum of GI Care

BACKGROUND

Although cognitive behavior therapies (CBTs) have shown great promise in the reduction of symptom burden from as well as anxiety around various gastrointestinal (GI) disorders, there are substantial issues involving the scalable delivery of such interventions within the clinical setting of a gastroenterology practice, leaving most patients without access to psychological care.

GOALS

This paper discusses the application of positive psychology principles and techniques for adoption by various GI providers to initiate early, effective psychological care for patients with GI disorders, saving CBTs for more complex cases.

STUDY/RESULTS

Authors provide a comprehensive framework of patient well-being known as REVAMP, which is consistent with CBT principles, and elaborate on research and interventions that can be adopted within the gastroenterology practice setting. Building positive resources can bolster patients with GI disorders against comorbid psychological and psychiatric distress.

CONCLUSIONS

Positive psychology interventions can be implemented within gastroenterology practice. Research is necessary to evaluate the efficacy and acceptability of positive psychology interventions among patients with different digestive disorders and baseline psychological characteristics, as well as the feasibility of administration by different clinicians in the gastroenterology practice setting.