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Sheard R, Davidson A. Sustained practice of Qigong results in a somatic hermeneutic process, contributing to appreciation of life. An interpretative phenomenological analysis. J Bodyw Mov Ther 2023; 36:100-108. [PMID: 37949545 DOI: 10.1016/j.jbmt.2023.06.002] [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: 01/13/2022] [Revised: 03/20/2023] [Accepted: 06/05/2023] [Indexed: 11/12/2023]
Abstract
Over the past few decades evidence has accumulated into the health benefits of practising Qigong, particularly in the amelioration of physical conditions. Previous studies have been conducted using positivist biomedical model methodologies, which may be limited in understanding the nuanced meaning-making and embodied experience of practitioners. This study uses Interpretative Phenomenological Analysis (IPA) to inquire into how the sustained practice of Qigong contributes beyond the relief of physical conditions to improved self-awareness and appreciation of life. Semi-structured interviews were conducted with five Qigong practitioners who each had over 10-years' experience and analysed using the interpretive methodology of IPA. Findings reveal a crucial antecedent theme of 'Openness to experience' and four, interrelated, super-ordinate themes common to each of the participants: 'Finding a Teacher', 'Bodymind' (proprioception and interoception), 'Primary Process of Developmental Change', and 'Awareness of emergent Authenticity'. Insights revealed how each practitioner makes sense of the sustained 'autotelic' practice of Qigong, and how this contributes to a transformative understanding of themselves and of life. Qigong presents a possible promising intervention to improve both physical and psychological well-being.
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Affiliation(s)
- Ruth Sheard
- School of Psychology, University of East London, UK.
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2
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Maiers M, Salsbury SA. "Like Peanut Butter and Jelly": A Qualitative Study of Chiropractic Care and Home Exercise Among Older Adults With Spinal Disability. Arthritis Care Res (Hoboken) 2022; 74:1933-1941. [PMID: 33973398 DOI: 10.1002/acr.24636] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 03/17/2021] [Accepted: 04/22/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE A mixed-methods, randomized controlled trial comparing short- and long-term chiropractic care and exercise therapy for spinal disability in older adults found no between-group differences in the primary outcome. However, those who received long-term management reported greater improvement in neck pain, self-efficacy, function, and balance. This nested qualitative study explored participants' perceptions of the benefits and drawbacks of chiropractic care and exercise for spine-related outcomes, with an emphasis on understanding what makes treatment for spine-related problems worthwhile. METHODS Of 171 individual interviews conducted after completing study treatment, 50 participants (25 per treatment group) were randomly selected for this analysis. Qualitative descriptive analysis included dual coding of verbatim transcripts by 2 investigators (MM and SAS), which was further distilled into a consensus-derived codebook of themes and organized using NVIVO software. RESULTS Participants described trial interventions as complementary to one another for spine-related disability. Chiropractic care was viewed as improving spinal pain and controlling symptoms, while exercise therapy was noted for its long-term impact on self-efficacy and self-management. These older adults considered changes in pain, global sense of improvement, and improved biomechanical function as making treatment worthwhile. CONCLUSION Older adults valued nonpharmacologic treatment options that aided them in controlling spine-related symptoms, while empowering them to maintain clinical benefit gained after a course of chiropractic spinal manipulation and exercise. The complementary nature of provider-delivered and active care modalities may be an important consideration when developing care plans. This study underscores the importance of understanding participants' values and experiences when interpreting study results and applying them to practice.
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Affiliation(s)
- Michele Maiers
- Northwestern Health Sciences University, Bloomington, Minnesota
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3
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Evans S, Livingstone A, Dodds M, Kotte D, Geertsema M, O’Shea M. Exploring Forest Therapy as an Adjunct to Treatment as Usual within a Community Health Counselling Service. JOURNAL OF SPIRITUALITY IN MENTAL HEALTH 2022. [DOI: 10.1080/19349637.2022.2106608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Affiliation(s)
- Subhadra Evans
- School of Psychology, Deakin University, Geelong, Australia
| | | | - Michael Dodds
- School of Psychology, Deakin University, Geelong, Australia
| | - Deiter Kotte
- International Nature and Forest Therapy Alliance, Australia
| | | | - Melissa O’Shea
- School of Psychology, Deakin University, Geelong, Australia
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4
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Schlee C, Uecker C, Bauer N, Koch AK, Langhorst J. Multimodal stress reduction and lifestyle modification program for patients with ulcerative colitis: a qualitative study. BMC Complement Med Ther 2022; 22:60. [PMID: 35260152 PMCID: PMC8903167 DOI: 10.1186/s12906-021-03478-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 12/03/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Over 2 million people in Europe are affected by ulcerative colitis, which often severely impacts the quality of life of those concerned. Among other factors, lifestyle and psychosocial factors seem to play an important role in pathogenesis and course of the disease and can be addressed as a complement to pharmacotherapy in comprehensive lifestyle modification programs. METHODS This qualitative study as part of a mixed methods approach was carried out in the framework of a randomized controlled trial that examined the effect of a comprehensive lifestyle-modification-program (10-week-day clinic program) on quality of life in patients with ulcerative colitis. Qualitative interviews were conducted with 20 out of 47 patients of the intervention group after the program. The aim was to deepen, supplement, and expand the quantitative results of the trial, i.e. to examine individual perceptions of the intervention, including subjective changes and the extent to which elements of the program were integrated into everyday life. Qualitative content analysis techniques utilizing the software MAXQDA were used. RESULTS Patients with ulcerative colitis in our sample often experienced multiple negative effects on different levels (physical, psychological, and social) and impaired quality of life because of their disease. They reported generally positively about the program itself, and emphasized perceived positive changes regarding their psychological and physical well-being. The interviews indicated a good implementation of elements learned during the intervention in everyday life. CONCLUSIONS Through participation in a comprehensive lifestyle modification program in the structure of a day clinic complementary to pharmacotherapy, patients with ulcerative colitis can reduce psychosocial stress and physical symptoms and thereby actively improve their well-being and general quality of life. This patient-centered, holistic approach was rated as useful in countering the complex disease manifestation as well as meeting the individual needs of the patients regarding their disease. TRIAL REGISTRATION clinicaltrials.gov NCT02721823.
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Affiliation(s)
- Christoph Schlee
- Department of Internal and Integrative Medicine, Sozialstiftung Bamberg, Buger Str. 80, 96049, Bamberg, Germany.,Department of Integrative Medicine, Medical Faculty, University of Duisburg-Essen, Buger Str. 80, 96049, Bamberg, Germany.,Department of Sociology, University of Bamberg, Feldkirchenstr. 21, 96052, Bamberg, Germany
| | - Christine Uecker
- Department of Internal and Integrative Medicine, Sozialstiftung Bamberg, Buger Str. 80, 96049, Bamberg, Germany.,Department of Integrative Medicine, Medical Faculty, University of Duisburg-Essen, Buger Str. 80, 96049, Bamberg, Germany
| | - Nina Bauer
- Department of Internal and Integrative Medicine, Sozialstiftung Bamberg, Buger Str. 80, 96049, Bamberg, Germany.,Department of Integrative Medicine, Medical Faculty, University of Duisburg-Essen, Buger Str. 80, 96049, Bamberg, Germany
| | - Anna K Koch
- Department of Integrative Medicine, Medical Faculty, University of Duisburg-Essen, Buger Str. 80, 96049, Bamberg, Germany.,Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Medical Faculty, University of Duisburg-Essen, Am Deimelsberg 34 a, 45276, Essen, Germany
| | - Jost Langhorst
- Department of Internal and Integrative Medicine, Sozialstiftung Bamberg, Buger Str. 80, 96049, Bamberg, Germany. .,Department of Integrative Medicine, Medical Faculty, University of Duisburg-Essen, Buger Str. 80, 96049, Bamberg, Germany.
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5
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Salsbury SA, Twist E, Wallace RB, Vining RD, Goertz CM, Long CR. Care Outcomes for Chiropractic Outpatient Veterans (COCOV): a qualitative study with veteran stakeholders from a pilot trial of multimodal chiropractic care. Pilot Feasibility Stud 2022; 8:6. [PMID: 35031072 PMCID: PMC8759237 DOI: 10.1186/s40814-021-00962-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 12/13/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Low back pain (LBP) is common among military veterans seeking treatment in Department of Veterans Affairs (VA) healthcare facilities. As chiropractic services within VA expand, well-designed pragmatic trials and implementation studies are needed to assess clinical effectiveness and program uptake. This study evaluated veteran stakeholder perceptions of the feasibility and acceptability of care delivery and research processes in a pilot trial of multimodal chiropractic care for chronic LBP. METHODS The qualitative study was completed within a mixed-method, single-arm, pragmatic, pilot clinical trial of chiropractic care for LBP conducted in VA chiropractic clinics. Study coordinators completed semi-structured, in person or telephone interviews with veterans near the end of the 10-week trial. Interviews were audiorecorded and transcribed verbatim. Qualitative content analysis using a directed approach explored salient themes related to trial implementation and delivery of chiropractic services. RESULTS Of 40 participants, 24 completed interviews (60% response; 67% male gender; mean age 51.7 years). Overall, participants considered the trial protocol and procedures feasible and reported that the chiropractic care and recruitment methods were acceptable. Findings were organized into 4 domains, 10 themes, and 21 subthemes. Chiropractic service delivery domain encompassed 3 themes/8 subthemes: scheduling process (limited clinic hours, scheduling future appointments, attendance barriers); treatment frequency (treatment sufficient for LBP complaint, more/less frequent treatments); and chiropractic clinic considerations (hire more chiropractors, including female chiropractors; chiropractic clinic environment; patient-centered treatment visits). Outcome measures domain comprised 3 themes/4 subthemes: questionnaire burden (low burden vs. time-consuming or repetitive); relevance (items relevant for LBP study); and timing and individualization of measures (questionnaire timing relative to symptoms, personalized approach to outcomes measures). The online data collection domain included 2 themes/4 subthemes: user concerns (little difficulty vs. form challenges, required computer skills); and technology issues (computer/internet access, junk mail). Clinical trial planning domain included 2 themes/5 subthemes: participant recruitment (altruistic service by veterans, awareness of chiropractic availability, financial compensation); and communication methods (preferences, potential barriers). CONCLUSIONS This qualitative study highlighted veteran stakeholders' perceptions of VA-based chiropractic services and offered important suggestions for conducting a full-scale, veteran-focused, randomized trial of multimodal chiropractic care for chronic LBP in this clinical setting. TRIAL REGISTRATION ClinicalTrials.gov NCT03254719.
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Affiliation(s)
- Stacie A. Salsbury
- Palmer Center for Chiropractic Research, Palmer College of Chiropractic, 741 Brady Street, Davenport, Iowa 52803 USA
| | - Elissa Twist
- Palmer Center for Chiropractic Research, Palmer College of Chiropractic, 741 Brady Street, Davenport, Iowa 52803 USA
| | - Robert B. Wallace
- Department of Epidemiology, College of Public Health, The University of Iowa, S422 CPHB, 145 N. Riverside Drive, Iowa City, Iowa 52242 USA
| | - Robert D. Vining
- Palmer Center for Chiropractic Research, Palmer College of Chiropractic, 741 Brady Street, Davenport, Iowa 52803 USA
| | - Christine M. Goertz
- Department of Orthopaedic Surgery, Duke University School of Medicine, 200 Morris Street, Durham, North Carolina 27701 USA
| | - Cynthia R. Long
- Palmer Center for Chiropractic Research, Palmer College of Chiropractic, 741 Brady Street, Davenport, Iowa 52803 USA
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Capon H, O'Shea M, Evans S, McIver S. Yoga complements cognitive behaviour therapy as an adjunct treatment for anxiety and depression: Qualitative findings from a mixed-methods study. Psychol Psychother 2021; 94:1015-1035. [PMID: 33834599 DOI: 10.1111/papt.12343] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 03/16/2021] [Indexed: 01/26/2023]
Abstract
OBJECTIVES Cognitive behaviour therapy (CBT) is recommended for treating anxiety and depression, demonstrating good efficacy and moderate rates of engagement. To further improve outcomes and access to evidence-based treatments, researchers have sought to enhance CBT protocols with mindfulness-based approaches, such as yoga. This study aimed to examine whether yoga is an acceptable and complementary adjunct to CBT through exploring the lived experiences of adults with anxiety and depression who engaged in an adjunct therapeutic yoga programme alongside group CBT. DESIGN Single-group qualitative design with post-intervention and follow-up timepoints. METHODS Thirty-six adults with anxiety and depression self-selected into a therapeutic yoga programme as an adjunct to group CBT. Qualitative interviews were conducted with 27 participants immediately after the eight-week programme and again three months later. Thematic analysis was used to identify common themes from the lived experiences. RESULTS Three primary themes, with nine subthemes, were identified which reflect the experiences of the combined therapies, the complementary elements, and process of engagement over time. The adjunct yoga programme was highly acceptable to adults with anxiety and depression, enhancing engagement and perceived outcomes. Yoga was identified as providing a unique combination of elements that complemented processes of CBT, such as behavioural activation and thought disputation. Yoga practices represented mental health self-management tools that are accessible and available as relapse prevention strategies. CONCLUSIONS Therapeutic yoga warrants consideration as an adjunct treatment for anxiety and depression as it offers unique and complementary elements to CBT and can enhance engagement and perceived clinical outcomes. PRACTITIONER POINTS Adults with anxiety and depression experienced a therapeutic yoga programme as a suitable and appealing adjunct that enhanced engagement with psychological treatment. Yoga offers a unique combination of elements, including a values system, body-based mindfulness practices, and breathing techniques, that complement CBT processes, such as behavioural activation, awareness of maladaptive patterns, and thought disputation. A therapeutic yoga programme provides adults with anxiety and depression with an accessible and sustainable mental health self-management tool. Therapeutic yoga can be considered for integration to models of mental health service provision to enhance engagement and clinical outcomes for adults with anxiety and depression.
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Affiliation(s)
- Hannah Capon
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Melissa O'Shea
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Subhadra Evans
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Shane McIver
- School of Health and Social Development, Deakin University, Burwood, Victoria, Australia
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Gilliam EA, Cheung T, Kraemer K, Litrownik D, Wayne PM, Moy ML, Yeh GY. The impact of Tai Chi and mind-body breathing in COPD: Insights from a qualitative sub-study of a randomized controlled trial. PLoS One 2021; 16:e0249263. [PMID: 33831022 PMCID: PMC8031883 DOI: 10.1371/journal.pone.0249263] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 03/12/2021] [Indexed: 11/19/2022] Open
Abstract
PURPOSE Chronic obstructive pulmonary disease (COPD) is associated with multiple psychosocial and behavioral factors. Prior research suggests that mind-body interventions may support the development and maintenance of healthy behaviors and improve health-related quality-of-life in such patients. We sought to qualitatively explore cognitive, psychosocial, and behavioral changes in patients with COPD who participated in two different mind-body interventions compared to an education control. METHODS We analyzed semi-structured qualitative exit interviews from a prospective, randomized pilot trial (N = 123) investigating 12-weeks of Tai Chi (TC) vs. mind-body breathing (MBB) vs. education (EDU) control in patients with moderate-severe COPD. TC involved traditional movements, that integrate meditative breathing, while MBB focused mainly on meditative breathing techniques alone. Interviews were audio-recorded and transcribed verbatim. Qualitative analysis of randomly selected transcripts was performed by two independent reviewers using an iterative process to identify emergent themes informed by grounded theory methods until thematic saturation was reached. RESULTS A total of 66 transcripts were reviewed (N = 22 TC, N = 22 MBB, N = 22 EDU). Participants were mean age = 68.1 years, GOLD Stage = 2.3, baseline FEV11 percent predicted mean (SD): 58% (13.4), 42.4% female. We identified six frequently mentioned themes: 1) overall awareness and understanding, 2) self-care knowledge, skills and behaviors, 3) behavior-related neurocognitive concepts, 4) physical function, 5) psychological well-being, and 6) social support/social function. Compared to EDU, more participants in TC and MBB noted improvements in awareness of self and the mind-body connection (e.g., body and breath awareness), knowledge of breathing techniques and integration of self-care skills with daily activities, self-efficacy for symptom management (particularly managing anxiety and dyspnea), acceptance of disease, physical function improvements (e.g., endurance, dyspnea, fatigue), and psychological well-being (particularly relaxation, emotion regulation and decreased reactivity). Compared to MBB, those in TC shared more intention to continue with self-care behaviors, physical activity self-efficacy, and improved flexibility. All three groups, including EDU, noted increased social support and knowledge of disease. Those in EDU, however, had fewer mentions of processes related to behavior change, and less concrete changes in neurocognitive, psychological, and physical function domains. CONCLUSIONS Mind-body interventions including meditative breathing may impact behavior-related neurocognitive and emotional factors that improve self-care management and support positive behavioral changes in patients with COPD. TRIAL REGISTRATION This trial is registered in Clinical Trials.gov, ID number NCT01551953.
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Affiliation(s)
- Elizabeth A. Gilliam
- Division of General Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Brookline, MA, United States of America
| | - Tina Cheung
- Division of General Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Brookline, MA, United States of America
| | - Kristen Kraemer
- Division of General Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Brookline, MA, United States of America
- Harvard Medical School, Boston, MA, United States of America
| | - Daniel Litrownik
- Division of General Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Brookline, MA, United States of America
| | - Peter M. Wayne
- Harvard Medical School, Boston, MA, United States of America
| | - Marilyn L. Moy
- Harvard Medical School, Boston, MA, United States of America
- Pulmonary and Critical Care Medicine Section, Department of Medicine, Veterans Administration Boston Healthcare System, Boston, MA, United States of America
| | - Gloria Y. Yeh
- Division of General Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Brookline, MA, United States of America
- Harvard Medical School, Boston, MA, United States of America
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Effect of Foot Reflexology Intervention on Depression, Anxiety, and Sleep Quality in Adults: A Meta-Analysis and Metaregression of Randomized Controlled Trials. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:2654353. [PMID: 33014101 PMCID: PMC7512096 DOI: 10.1155/2020/2654353] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 08/20/2020] [Accepted: 09/05/2020] [Indexed: 12/25/2022]
Abstract
Objectives The aim of this study was to conduct a systematic review, meta-analysis, and metaregression to determine the current best available evidence of the efficacy and safety of foot reflexology for adult depression, anxiety, and sleep quality. Methods Electronic databases (PubMed, ClinicalKey, ScienceDirect, EMBASE, PsycINFO, and the Cochrane Library) were searched till August, 10, 2020, and the validity of the eligible studies was critically appraised. Randomized controlled trials comparing foot reflexology groups with control groups for adult depression, anxiety, and sleep quality were included. Twenty-six eligible studies were included to assess the effect of foot reflexology intervention on the reducing symptoms of depression and anxiety and improving quality of sleep, respectively, as the primary outcome. Results Twenty-six randomized controlled trials involving 2,366 participants met the inclusion criteria. The meta-analyses showed that foot reflexology intervention significantly improved adult depression (Hedges' g = −0.921; 95% CI: −1.246 to −0.595; P < 0.001), anxiety (Hedges' g = −1.237; 95% CI −1.682 to −0.791; P < 0.001), and sleep quality (Hedges' g = −1.665; 95% CI −2.361 to −0.970; P < 0.001). Metaregression reveals that an increase in total foot reflexology time (P = 0.002) and duration (P = 0.01) can significantly improve sleep quality. Conclusions Foot reflexology may provide additional nonpharmacotherapy intervention for adults suffering from depression, anxiety, or sleep disturbance. However, high quality and rigorous design RCTs in specific population, along with an increase in participants, and a long-term follow-up are recommended in the future.
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Kelemen A, Anderson E, Jordan K, Cates LC, Shipp G, Groninger H. "I Didn't Know Massages Could Do That:" A qualitative analysis of the perception of hospitalized patients receiving massage therapy from specially trained massage therapists. Complement Ther Med 2020; 52:102509. [PMID: 32951756 DOI: 10.1016/j.ctim.2020.102509] [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] [Received: 08/09/2019] [Revised: 07/07/2020] [Accepted: 07/08/2020] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE This study examined the perception and experience of hospitalized palliative care eligible patients receiving massage therapy from specially trained massaged therapist. DESIGN Twenty hospitalized palliative care eligible patients received three differing doses of massage therapy from specially trained massage therapists. Patients were interviewed about their experience and perception related to the massage. Open-ended data were collected and analyzed using a grounded theory approach. SETTING 912-bed tertiary hospital center in Washington, DC. RESULTS Participants generally perceived the hospital-based massage experience positively. Participants noted how the massage experience provoked reflection on the overall hospital experience in two ways: first, as a reference point to the inpatient environment itself, and second, in terms of how massage reduces this distress and creates a sense of peace, at least temporarily. CONCLUSION The data collected in these semi-structured interviews showed that massage therapy can uniquely ameliorate some of the most pervasive challenges to quality of life for hospitalized patients affected by chronic and serious illness.
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Affiliation(s)
- Anne Kelemen
- Georgetown University Medical Center/MedStar Washington Hospital Center, Washington, DC, United States.
| | | | | | | | - Gianna Shipp
- Georgetown University Medical Center/MedStar Washington Hospital Center, Washington, DC, United States
| | - Hunter Groninger
- Georgetown University Medical Center/MedStar Washington Hospital Center, Washington, DC, United States
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Bratberg G, Leira K, Granan LP, Jonsbu E, Fadnes BL, Thuland SF, Myklebust TÅ. Learning oriented physiotherapy (LOP) in anxiety and depression: an 18 months multicentre randomised controlled trial (RCT). EUROPEAN JOURNAL OF PHYSIOTHERAPY 2020. [DOI: 10.1080/21679169.2020.1739747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Grete Bratberg
- Faculty of Nursing and Health Sciences, Nord University, Levanger, Norway
- Department of Research, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Kirsti Leira
- Department of Psychiatry, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Lars-Petter Granan
- Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
| | - Egil Jonsbu
- Department of Psychiatry, Møre and Romsdal Hospital Trust, Molde, Norway
- Department of Mental Health, Faculty of Medicine and Health Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Britt Lenes Fadnes
- Department of Psychiatry, Møre and Romsdal Hospital Trust, Molde, Norway
| | | | - Tor Åge Myklebust
- Department of Research and Innovation, Møre and Romsdal Hospital Trust, Ålesund, Norway
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11
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Probiotics for Childhood Functional Gastrointestinal Disorders: Do We Know What We Advise? PHARMANUTRITION 2019. [DOI: 10.1016/j.phanu.2019.100160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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12
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Capon H, O'Shea M, McIver S. Yoga and mental health: A synthesis of qualitative findings. Complement Ther Clin Pract 2019; 37:122-132. [DOI: 10.1016/j.ctcp.2019.101063] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 09/27/2019] [Accepted: 09/27/2019] [Indexed: 12/14/2022]
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13
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Rebsamen S, Knols RH, Pfister PB, de Bruin ED. Exergame-Driven High-Intensity Interval Training in Untrained Community Dwelling Older Adults: A Formative One Group Quasi- Experimental Feasibility Trial. Front Physiol 2019; 10:1019. [PMID: 31440168 PMCID: PMC6693477 DOI: 10.3389/fphys.2019.01019] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 07/24/2019] [Indexed: 12/31/2022] Open
Abstract
Purpose To investigate the feasibility of an exergame-driven high-intensity interval training (HIIT) and its effects on cardiovascular fitness in untrained community dwelling older adults. Methods Twelve older participants [10 women, age 72.3 (SD: 4.44) years] performed a high-intensity interval exergame intervention three times a week for 4 weeks. Data was acquired during two baseline and one final measurement. Feasibility outcomes included attrition, adherence, acceptability [Technology Acceptance Model Questionnaire (TAM)], usability [System Usability Scale (SUS)], and enjoyment of exergaming. Furthermore, participants' physical activity levels pre and post intervention were compared to physical activity levels for similar types of training. The secondary outcome was exercise capacity [heart rate at rest (HRrest), heart rate variability (HRV), maximum heart rate (HRmax), and maximum workload (W, in watt)] evaluated through maximal exercise testing. Results Eleven participants completed the study (8% attrition), without any adverse events. Adherence to the HIIT intervention was 91% and participants showed high acceptance of the intervention with TAM scores between 5.8 and 6.7 points. User satisfaction was rated as excellent (SUS total score: 93.5 of 100) and the overall enjoyment of exergaming scored 4.5 of 5 possible points. Total exercise time ranged from 19 to 35 min with a mean of 30.8 (SD: 3.6) min. Actual high-intensity exercise time showed consistency with the target exercise time in 98% percent of trainings. Eighty-six percent of high-intensity intervals met the targeted intensity range (>70-90% of HRmax). Thirty-six percent of the recovery periods were completed with a heart rate above the target range of 50-70% of HRmax. Maximum workload (W) during the incremental exercise test post-training increased significantly compared to the baseline measurements one and two (p = 0.032, effect size r = 0.77 and p = 0.012, r = 0.87). Conclusion High-intensity interval training through exergaming is feasible, safe, and shows high usability and acceptance in community dwelling older people. Exergame-driven HIIT had a significant effect on maximum power output on an incremental exercise test. A more extensive exergame intervention period, higher work to recovery ratios as well as a higher-intensity activity should be considered in future projects.
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Affiliation(s)
- Stefanie Rebsamen
- Directorate of Research and Education, Physiotherapy and Occupational Therapy Research Center, University Hospital Zurich, Zurich, Switzerland.,Institute of Physiotherapy, Zurich University of Applied Sciences, Winterthur, Switzerland.,Institute of Physiotherapy, Kantonsspital Winterthur, Winterthur, Switzerland
| | - Ruud H Knols
- Directorate of Research and Education, Physiotherapy and Occupational Therapy Research Center, University Hospital Zurich, Zurich, Switzerland.,Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
| | - Pierrette Baschung Pfister
- Directorate of Research and Education, Physiotherapy and Occupational Therapy Research Center, University Hospital Zurich, Zurich, Switzerland
| | - Eling D de Bruin
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland.,Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
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14
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Friesen P. Mesmer, the placebo effect, and the efficacy paradox: lessons for evidence based medicine and complementary and alternative medicine. CRITICAL PUBLIC HEALTH 2019. [DOI: 10.1080/09581596.2019.1597967] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Phoebe Friesen
- Nuffield Department of Population Health, University of Oxford - Ethox Centre, Oxford, United Kingdom of Great Britain and Northern Ireland
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15
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Ijaz N, Rioux J, Elder C, Weeks J. Whole Systems Research Methods in Health Care: A Scoping Review. J Altern Complement Med 2019; 25:S21-S51. [PMID: 30870019 PMCID: PMC6447996 DOI: 10.1089/acm.2018.0499] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Objectives: This scoping review evaluates two decades of methodological advances made by “whole systems research” (WSR) pioneers in the fields of traditional, complementary, and integrative medicine (TCIM). Rooted in critiques of the classical randomized controlled trial (RCT)'s suitability for evaluating holistic, complex TCIM interventions, WSR centralizes the principle of “model validity,” representing a “fit” between research design and therapeutic paradigm. Design: In consultation with field experts, 41 clinical research exemplars were selected for review from across 13 TCIM disciplines, with the aim of mapping the range and methodological characteristics of WSR studies. Using an analytic charting approach, these studies' primary and secondary features are characterized with reference to three focal areas: research method, intervention design, and outcome assessment. Results: The reviewed WSR exemplars investigate a wide range of multimodal and multicomponent TCIM interventions, typified by wellness-geared, multitarget, and multimorbid therapeutic aims. Most studies include a behavioral focus, at times in multidisciplinary or team-based contexts. Treatments are variously individualized, often with reference to “dual” (biomedical and paradigm-specific) diagnoses. Prospective and retrospective study designs substantially reflect established biomedical research methods. Pragmatic, randomized, open label comparative effectiveness designs with “usual care” comparators are most widely used, at times with factorial treatment arms. Only two studies adopt a double-blind, placebo-controlled RCT format. Some cohort-based controlled trials engage nonrandomized allocation strategies (e.g., matched controls, preference-based assignment, and minimization); other key designs include single-cohort pre–post studies, modified n-of-1 series, case series, case report, and ethnography. Mixed methods designs (i.e., qualitative research and economic evaluations) are evident in about one-third of exemplars. Primary and secondary outcomes are predominantly assessed, at multiple intervals, through patient-reported measures for symptom severity, quality of life/wellness, and/or treatment satisfaction; some studies concurrently evaluate objective outcomes. Conclusions: Aligned with trends emphasizing “fit-for-purpose” research designs to study the “real-world” effectiveness of complex, personalized clinical interventions, WSR has emerged as a maturing scholarly discipline. The field is distinguished by its patient-centered salutogenic focus and engagement with nonbiomedical diagnostic and treatment frameworks. The rigorous pursuit of model validity may be further advanced by emphasizing complex analytic models, paradigm-specific outcome assessment, inter-rater reliability, and ethnographically informed designs. Policy makers and funders seeking to support best practices in TCIM research may refer to this review as a key resource.
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Affiliation(s)
- Nadine Ijaz
- 1 Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada
| | | | - Charles Elder
- 3 Kaiser Permanente Center for Health Research, Portland, OR
| | - John Weeks
- 4 johnweeks-integrator.com, Editor-in-Chief, JACM, Seattle, WA
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16
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An Invitation to Live: Insights from an Older, Long-Term Practitioner of Tai Chi. PHYSICAL ACTIVITY AND HEALTH 2019. [DOI: 10.5334/paah.31] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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17
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van Vliet M, Jong MC, Jong M. A Mind-Body Skills Course Among Nursing and Medical Students: A Pathway for an Improved Perception of Self and the Surrounding World. Glob Qual Nurs Res 2018; 5:2333393618805340. [PMID: 30349869 PMCID: PMC6194914 DOI: 10.1177/2333393618805340] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 09/02/2018] [Accepted: 09/10/2018] [Indexed: 11/17/2022] Open
Abstract
Despite increased recognition of self-care and self-awareness as core competences for health care professionals, little attention is paid to these skills during their education. Evidence suggests that a Mind-Body (MB) skills course has the potential to enhance self-care and self-awareness among medical students. However, less is known about the meaning of this course for students and how it affects their personal and professional life. Therefore, we examined the lived experiences with an MB skills course among Dutch medical and Swedish nursing students. This course included various MB techniques, such as mindfulness meditation and guided imagery. Guided by a phenomenological hermeneutical method, three main themes were identified: "ability to be more present," "increased perception and awareness of self," and "connection on a deeper level with others." Overall, participation in the MB skills course served as a pathway to inner awareness and supported connecting with others as well as with the surrounding world.
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Affiliation(s)
- Marja van Vliet
- Louis Bolk Institute, Bunnik, The Netherlands.,Mid Sweden University, Sundsvall, Sweden
| | - Miek C Jong
- Louis Bolk Institute, Bunnik, The Netherlands.,Mid Sweden University, Sundsvall, Sweden
| | - Mats Jong
- Mid Sweden University, Sundsvall, Sweden
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18
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Kishida M, Mama SK, Larkey LK, Elavsky S. “Yoga resets my inner peace barometer”: A qualitative study illuminating the pathways of how yoga impacts one’s relationship to oneself and to others. Complement Ther Med 2018; 40:215-221. [DOI: 10.1016/j.ctim.2017.10.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 10/06/2017] [Accepted: 10/08/2017] [Indexed: 01/03/2023] Open
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19
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Ooi SL, Smith L, Pak SC. Evidence-informed massage therapy - an Australian practitioner perspective. Complement Ther Clin Pract 2018; 31:325-331. [PMID: 29705477 DOI: 10.1016/j.ctcp.2018.04.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 03/08/2018] [Accepted: 04/06/2018] [Indexed: 11/19/2022]
Abstract
Massage therapy (MT) is the most popular complementary and alternative medicine therapy used by the Australian public. With the growing emphasis by the Australian health authority on evidence-informed healthcare decision-making, there is an increasing demand for massage therapists to move towards the evidence-informed practice (EIP). With MT research gaining significant attention over the last 30 years, clinical evidence exists to support the efficacies of MT on many health conditions, including chronic low back pain. This growing body of research supports MT to become an evidence-informed therapeutic modality. The evidence utilization process of asking clinical questions, searching for available research evidence, and appraising the evidence critically can be incorporated into the clinical practice of MT. Moreover, integrating practitioners' skills and experience with research evidence enables the best treatment plan to address the clients' needs and stated goals. No dichotomy exists between scientific research and the humanistic client care of MT. A massage therapist can gain greater confidence in practice, improve critical thinking and decision-making skills, and increase career satisfaction through EIP. Despite its high public utilization, massage therapists in Australia remain a low-paying profession dominated by part-time workers who rarely utilize research evidence in practice. Professional associations of massage therapists in Australia need to play a key role in promoting EIP through continuing professional education, providing the access to research information and resources, as well as fostering a culture of EIP.
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Affiliation(s)
- Soo Liang Ooi
- Centre for Complementary & Alternative Medicine, 247909, Singapore
| | - Lauren Smith
- School of Biomedical Sciences, Charles Sturt University, Bathurst, NSW 2795, Australia
| | - Sok Cheon Pak
- School of Biomedical Sciences, Charles Sturt University, Bathurst, NSW 2795, Australia.
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20
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de Almeida Andrade F, Schlechta Portella CF. Research methods in complementary and alternative medicine: an integrative review. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2017; 16:6-13. [PMID: 29397095 DOI: 10.1016/j.joim.2017.12.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 06/01/2017] [Indexed: 11/18/2022]
Abstract
The scientific literature presents a modest amount of evidence in the use of complementary and alternative medicine (CAM). On the other hand, in practice, relevant results are common. The debates among CAM practitioners about the quality and execution of scientific research are important. Therefore, the aim of this review is to gather, synthesize and describe the differentiated methodological models that encompass the complexity of therapeutic interventions. The process of bringing evidence-based medicine into clinical practice in CAM is essential for the growth and strengthening of complementary medicines worldwide.
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21
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Pham MH, Elshehabi M, Haertner L, Del Din S, Srulijes K, Heger T, Synofzik M, Hobert MA, Faber GS, Hansen C, Salkovic D, Ferreira JJ, Berg D, Sanchez-Ferro Á, van Dieën JH, Becker C, Rochester L, Schmidt G, Maetzler W. Validation of a Step Detection Algorithm during Straight Walking and Turning in Patients with Parkinson's Disease and Older Adults Using an Inertial Measurement Unit at the Lower Back. Front Neurol 2017; 8:457. [PMID: 28928711 PMCID: PMC5591331 DOI: 10.3389/fneur.2017.00457] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 08/17/2017] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Inertial measurement units (IMUs) positioned on various body locations allow detailed gait analysis even under unconstrained conditions. From a medical perspective, the assessment of vulnerable populations is of particular relevance, especially in the daily-life environment. Gait analysis algorithms need thorough validation, as many chronic diseases show specific and even unique gait patterns. The aim of this study was therefore to validate an acceleration-based step detection algorithm for patients with Parkinson's disease (PD) and older adults in both a lab-based and home-like environment. METHODS In this prospective observational study, data were captured from a single 6-degrees of freedom IMU (APDM) (3DOF accelerometer and 3DOF gyroscope) worn on the lower back. Detection of heel strike (HS) and toe off (TO) on a treadmill was validated against an optoelectronic system (Vicon) (11 PD patients and 12 older adults). A second independent validation study in the home-like environment was performed against video observation (20 PD patients and 12 older adults) and included step counting during turning and non-turning, defined with a previously published algorithm. RESULTS A continuous wavelet transform (cwt)-based algorithm was developed for step detection with very high agreement with the optoelectronic system. HS detection in PD patients/older adults, respectively, reached 99/99% accuracy. Similar results were obtained for TO (99/100%). In HS detection, Bland-Altman plots showed a mean difference of 0.002 s [95% confidence interval (CI) -0.09 to 0.10] between the algorithm and the optoelectronic system. The Bland-Altman plot for TO detection showed mean differences of 0.00 s (95% CI -0.12 to 0.12). In the home-like assessment, the algorithm for detection of occurrence of steps during turning reached 90% (PD patients)/90% (older adults) sensitivity, 83/88% specificity, and 88/89% accuracy. The detection of steps during non-turning phases reached 91/91% sensitivity, 90/90% specificity, and 91/91% accuracy. CONCLUSION This cwt-based algorithm for step detection measured at the lower back is in high agreement with the optoelectronic system in both PD patients and older adults. This approach and algorithm thus could provide a valuable tool for future research on home-based gait analysis in these vulnerable cohorts.
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Affiliation(s)
- Minh H Pham
- Department of Neurology, University of Kiel, Kiel, Germany.,Digital Signal Processing and System Theory, Faculty of Engineering, University of Kiel, Kiel, Germany
| | - Morad Elshehabi
- Department of Neurology, University of Kiel, Kiel, Germany.,Center for Neurology, Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen, Tübingen, Germany
| | - Linda Haertner
- Center for Neurology, Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen, Tübingen, Germany.,DZNE, German Center for Neurodegenerative Diseases, Tübingen, Germany
| | - Silvia Del Din
- Institute of Neuroscience/Newcastle University Institute for Ageing, Clinical Ageing Research Unit, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Karin Srulijes
- Department of Clinical Gerontology, Robert Bosch Hospital, Stuttgart, Germany
| | - Tanja Heger
- Center for Neurology, Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen, Tübingen, Germany.,DZNE, German Center for Neurodegenerative Diseases, Tübingen, Germany
| | - Matthis Synofzik
- Center for Neurology, Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen, Tübingen, Germany.,DZNE, German Center for Neurodegenerative Diseases, Tübingen, Germany
| | - Markus A Hobert
- Department of Neurology, University of Kiel, Kiel, Germany.,Center for Neurology, Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen, Tübingen, Germany
| | - Gert S Faber
- Department of Human Movement Sciences, MOVE Research Institute Amsterdam, VU University Amsterdam, Amsterdam, Netherlands
| | - Clint Hansen
- Department of Neurology, University of Kiel, Kiel, Germany
| | - Dina Salkovic
- Center for Neurology, Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen, Tübingen, Germany
| | - Joaquim J Ferreira
- Clinical Pharmacology Unit, Instituto de Medicina Molecular, Lisbon, Portugal.,Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Daniela Berg
- Department of Neurology, University of Kiel, Kiel, Germany.,Center for Neurology, Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen, Tübingen, Germany
| | - Álvaro Sanchez-Ferro
- HM CINAC, Hospital Universitario HM Puerta del Sur, Móstoles, Madrid, Spain.,Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Jaap H van Dieën
- Department of Human Movement Sciences, MOVE Research Institute Amsterdam, VU University Amsterdam, Amsterdam, Netherlands
| | - Clemens Becker
- Department of Clinical Gerontology, Robert Bosch Hospital, Stuttgart, Germany
| | - Lynn Rochester
- Institute of Neuroscience/Newcastle University Institute for Ageing, Clinical Ageing Research Unit, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, United Kingdom.,Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Gerhard Schmidt
- Digital Signal Processing and System Theory, Faculty of Engineering, University of Kiel, Kiel, Germany
| | - Walter Maetzler
- Department of Neurology, University of Kiel, Kiel, Germany.,Center for Neurology, Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen, Tübingen, Germany
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Colgan DD, Wahbeh H, Pleet M, Besler K, Christopher M. A Qualitative Study of Mindfulness Among Veterans With Posttraumatic Stress Disorder: Practices Differentially Affect Symptoms, Aspects of Well-Being, and Potential Mechanisms of Action. J Evid Based Complementary Altern Med 2017; 22:482-493. [PMID: 30208735 PMCID: PMC5871168 DOI: 10.1177/2156587216684999] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 10/13/2016] [Accepted: 11/21/2016] [Indexed: 11/16/2022] Open
Abstract
This qualitative study explored and compared the subjective experiences of 102 veterans with posttraumatic stress disorder (PTSD) who were randomly assigned to 1 of 4 arms: ( a) body scan, ( b) mindful breathing, ( c) slow breathing, or ( d) sitting quietly. Qualitative data were obtained via semistructured interviews following the intervention and analyzed using conventional content analysis. The percentage of participants within each intervention who endorsed a specific theme was calculated. Two-proportion z tests were then calculated to determine if the differences among themes endorsed in specific groups were statistically significant. Six core themes emerged from analysis of participant responses across the 4 groups: ( a) enhanced present moment awareness, ( b) increased nonreactivity, ( c) increased nonjudgmental acceptance, ( d) decreased physiological arousal and stress reactivity, ( e) increased active coping skills, and ( f) greater relaxation. More participants in the mindfulness intervention groups reported improvement in PTSD symptoms when compared to participants in non-mindfulness groups. Different types of intervention targeted different symptoms and aspects of well-being. Furthermore, type of intervention may have also differentially targeted potential mechanisms of action. This article highlights the importance of employing both quantitative and qualitative research methods when investigating the dynamic process of mindfulness and may inform how practices can be tailored to the needs of the veteran with PTSD.
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Affiliation(s)
| | - Helané Wahbeh
- Oregon Health & Science University, Portland, OR, USA
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23
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Ali A, Rosenberger L, Weiss TR, Milak C, Perlman AI. Massage Therapy and Quality of Life in Osteoarthritis of the Knee: A Qualitative Study. PAIN MEDICINE 2017; 18:1168-1175. [PMID: 27590465 DOI: 10.1093/pm/pnw217] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Objective We hypothesized that participants receiving Swedish massage would experience benefits such as stress reduction and enhanced quality of life, in addition to the osteoarthritis-specific effects assessed in a randomized controlled clinical trial. Design Qualitative methods were used to explore a deeper contextual understanding of participants' experiences with massage and osteoarthritis, in addition to the quantitative data collected from primary and secondary outcome measures of the dose-finding study. Setting Two community hospitals affiliated with academic health centers in Connecticut and New Jersey. Subjects Eighteen adults who previously participated in a dose-finding clinical trial of massage therapy for osteoarthritis of the knee. Methods Face-to-face and telephone interviews using a standardized interview guide. Triangulation of qualitative and quantitative data allowed for a more thorough understanding of the effects of massage therapy. Results Three salient themes emerged from our analysis. Participants discussed 1) relaxation effects, 2) improved quality of life associated with receiving massage therapy, and 3) the accessibility of massage therapy in treating osteoarthritis. Conclusions Participant responses noted empowerment with an improved ability to perform activities of daily living after experiencing massage therapy. The majority of statements were consistent with their quantitative changes on standard osteoarthritis measures. Future research in pain conditions should include health-related quality of life assessments as well as outcomes related to perceived well-being, along with greater exploration of the concept of salutogenic side effects of an intervention in the context of complementary and integrative therapies.
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Affiliation(s)
- Ather Ali
- Yale School of Medicine, New Haven, Connecticut
| | - Lisa Rosenberger
- Yale-Griffin Prevention Research Center, Yale School of Public Health, Derby, Connecticut
| | | | - Carl Milak
- Institute for Complementary and Alternative Medicine, School of Health Related Professions, Rutgers University, Newark, New Jersey
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Kastner J, Milford C, Akatukwasa C, Kembabazi A, Smit J. Implementing a Global Health Qualitative Research Study: Experiences of a Project Coordinator in Uganda. East Afr Health Res J 2017; 1:113-122. [PMID: 34308165 PMCID: PMC8279193 DOI: 10.24248/eahrj-d-16-00343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 07/20/2017] [Indexed: 11/20/2022] Open
Abstract
Qualitative research in global health requires substantial operational and logistical support during both the implementation phase and day-to-day operations. However, little to no published work shares the experiences of international qualitative research teams. Yet, without a strong project foundation and attention to everyday details, studies can begin without appropriate guidance and, as a result, poor quality data may be generated. This paper presents a detailed account of a project coordinator's experience implementing 4 qualitative HIV and reproductive health studies in Uganda between 2012 and 2014, reflecting on our research team's practices and lessons learnt, and provides recommendations for successful project implementation. The aim of this paper is to help new global health qualitative project coordinators, and international teams more generally, by detailing 6 coordination tasks: hiring, training, team communication, organization of study documents, data collection and storage, and research ethics. To avoid repeat learning of basic, yet important, logistical steps by each new qualitative research project coordinator, this paper can help coordinators think about how to organize their work in order to prepare for both planned and unplanned challenges that have been encountered by others. Sharing operational and logistical experiences and expertise can benefit the global health community and help future studies run more efficiently.
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Affiliation(s)
- Jasmine Kastner
- McGill University Health Centre, Research Institute, Montreal, Canada
| | - Cecilia Milford
- University of the Witwatersrand, Faculty of Health Sciences, Durban, South Africa
| | | | - Annet Kembabazi
- Mbarara University of Science and Technology, Mbarara, Uganda
| | - Jenni Smit
- University of the Witwatersrand, Faculty of Health Sciences, Durban, South Africa
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25
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Boitor M, Martorella G, Arbour C, Michaud C, Gélinas C. Evaluation of the preliminary effectiveness of hand massage therapy on postoperative pain of adults in the intensive care unit after cardiac surgery: a pilot randomized controlled trial. Pain Manag Nurs 2016; 16:354-66. [PMID: 26025795 DOI: 10.1016/j.pmn.2014.08.014] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Revised: 08/26/2014] [Accepted: 08/26/2014] [Indexed: 11/26/2022]
Abstract
Although many intensive care unit patients experience significant pain, very few studies explored massage to maximize their pain relief. This study aimed to evaluate the preliminary effects of hand massage on pain after cardiac surgery in the adult intensive care unit. A pilot randomized controlled trial was used for this study. The study was conducted in a Canadian medical-surgical intensive care unit. Forty adults who were admitted to the intensive care unit after undergoing elective cardiac surgery in the previous 24 hours participated in the study. They were randomly assigned to the experimental (n = 21) or control (n = 19) group. The experimental group received a 15-minute hand massage, and the control group received a 15-minute hand-holding without massage. In both groups the intervention was followed by a 30-minute rest period. The interventions were offered on 2-3 occasions within 24 hours after surgery. Pain, muscle tension, and vital signs were assessed. Pain intensity and behavioral scores were decreased for the experimental group. Although hand massage decreased muscle tension, fluctuations in vital signs were not significant. This study supports potential benefits of hand massage for intensive care unit postoperative pain management. Although larger randomized controlled trials are necessary, this low-cost nonpharmacologic intervention can be safely administered.
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Affiliation(s)
- Mădălina Boitor
- Ingram School of Nursing, McGill University, Montréal, Québec, Canada
| | - Géraldine Martorella
- Ingram School of Nursing, McGill University, Montréal, Québec, Canada; Quebec Nursing Intervention Research Network (RRISIQ), Montréal, Québec, Canada; Faculty of Nursing, Université de Montréal, Montréal, Québec, Canada
| | - Caroline Arbour
- Ingram School of Nursing, McGill University, Montréal, Québec, Canada; Quebec Nursing Intervention Research Network (RRISIQ), Montréal, Québec, Canada; Alan Edwards Centre for Research on Pain, McGill University, Montréal, Québec, Canada
| | - Cécile Michaud
- Quebec Nursing Intervention Research Network (RRISIQ), Montréal, Québec, Canada; School of Nursing, Univeristé de Sherbrooke, Sherbrooke, Québec, Canada
| | - Céline Gélinas
- Ingram School of Nursing, McGill University, Montréal, Québec, Canada; Centre for Nursing Research and Lady Davis Institute, Jewish General Hospital, Montréal, Québec, Canada; Quebec Nursing Intervention Research Network (RRISIQ), Montréal, Québec, Canada; Alan Edwards Centre for Research on Pain, McGill University, Montréal, Québec, Canada.
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26
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Walker J, Sofaer B. Randomised controlled trials in the evaluation of non-biomedical therapeutic interventions for pain: The gold standard? J Res Nurs 2016. [DOI: 10.1177/136140960300800502] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This paper offers a critical review of important issues in the implementation and interpretation of randomised controlled trials (RCTs) used to evaluate non-biomedical therapeutic interventions for pain. The analysis of methodological issues focuses on the validity, relevance and clinical importance of outcome measures; sampling and randomization bias; blinding procedures used to control for the placebo response and therapist influences, and treatment standardisation. A key issue is that pain management is inextricably linked to the establishment of a therapeutic relationship. In such circumstances, it is argued that the 'gold standard' double-blind RCT is impracticable. Those relying on RCTs as sources of evidence need to be aware that an 'unblinded' RCT can enhance placebo responses to the intervention and introduce important sources of bias. The challenge faced by healthcare researchers is to identify alternative research designs able to provide valid and reliable evidence that the proposed therapeutic intervention is capable of achieving cost-effective, clinically important and personally relevant outcomes in naturalistic settings.
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Affiliation(s)
- Jan Walker
- School of Nursing and Midwifery University of Southampton
| | - Beatrice Sofaer
- Clinical Research Centre for Health Professions, Faculty of Health, University of Brighton, East Sussex
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27
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Koithan M, Bell IR, Caspi O, Ferro L, Brown V. Patients' Experiences and Perceptions of a Consultative Model Integrative Medicine Clinic: A Qualitative Study. Integr Cancer Ther 2016; 6:174-84. [PMID: 17548796 DOI: 10.1177/1534735407301992] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective: A common theme in integrative medicine (IM) is patient-centered partnering in care between patients and providers. Despite the stated ideals, few studies have assessed patients' perspectives on their actual experience in the context of a specific care model. The purpose of the present study was to retrospectively explore and compare experiences of cancer and noncancer patients under care in a consultative IM outpatient teaching clinic in the south-western United States. Design: Qualitative study using inductive content analysis of focus group interview transcripts (2 groups of adult patients with cancers of various types and 1 group of chronically ill noncancer patients with mixed diagnoses). Method: Participants were recruited by random selection from a pool of eligible patients. Groups were conducted with patients who had completed their initial conventional cancer treatment and were at least 6 months postconsultation with an IM clinic physician. Transcripts of the audiotaped focus groups were analyzed. Results: Cancer patients (n = 15) and noncancer patients (n = 6) (mean age, 60 years; 77% women) expressed overall satisfaction with IM, emphasizing (1) expansion of treatment options with lower perceived toxicity than conventional therapies, (2) positive experiences of the IM physician as caring and taking time to listen, and (3) improved self-care skills and sense of empowerment. Cancer patients noted positive relationships with their conventional MDs more than did noncancer patients, although both groups appreciated the IM physicians' communication styles. Conclusion: Patients experience a consultative integrative clinic model overall as favorable. The impact on outcomes, costs, and long-term quality of life requires additional study.
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Affiliation(s)
- Mary Koithan
- Department of Medicine (Program in Integrative Medicine) at The University of Arizona Health Sciences Center, Tucson, AZ 85724-5153, USA.
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28
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Tsang KL, Carlson LE, Olson K. Pilot Crossover Trial of Reiki Versus Rest for Treating Cancer-Related Fatigue. Integr Cancer Ther 2016; 6:25-35. [PMID: 17351024 DOI: 10.1177/1534735406298986] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Fatigue is an extremely common side effect experienced during cancer treatment and recovery. Limited research has investigated strategies stemming from complementary and alternative medicine to reduce cancer-related fatigue. This research examined the effects of Reiki, a type of energy touch therapy, on fatigue, pain, anxiety, and overall quality of life. This study was a counterbalanced crossover trial of 2 conditions: (1) in the Reiki condition, participants received Reiki for 5 consecutive daily sessions, followed by a 1-week washout monitoring period of no treatments, then 2 additional Reiki sessions, and finally 2 weeks of no treatments, and (2) in the rest condition, participants rested for approximately 1 hour each day for 5 consecutive days, followed by a 1-week washout monitoring period of no scheduled resting and an additional week of no treatments. In both conditions, participants completed questionnaires investigating cancer-related fatigue (Functional Assessment of Cancer Therapy Fatigue subscale [FACT-F]) and overall quality of life (Functional Assessment of Cancer Therapy, General Version [FACT-G]) before and after all Reiki or resting sessions. They also completed a visual analog scale (Edmonton Symptom Assessment System [ESAS]) assessing daily tiredness, pain, and anxiety before and after each session of Reiki or rest. Sixteen patients (13 women) participated in the trial: 8 were randomized to each order of conditions (Reiki then rest; rest then Reiki). They were screened for fatigue on the ESAS tiredness item, and those scoring greater than 3 on the 0 to 10 scale were eligible for the study. They were diagnosed with a variety of cancers, most commonly colorectal (62.5%) cancer, and had a median age of 59 years. Fatigue on the FACT-F decreased within the Reiki condition ( P=.05) over the course of all 7 treatments. In addition, participants in the Reiki condition experienced significant improvements in quality of life (FACT-G) compared to those in the resting condition ( P <.05). On daily assessments (ESAS) in the Reiki condition, presession 1 versus postsession 5 scores indicated significant decreases in tiredness ( P <.001), pain ( P <.005), and anxiety ( P<.01), which were not seen in the resting condition. Future research should further investigate the impact of Reiki using more highly controlled designs that include a sham Reiki condition and larger sample sizes.
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Affiliation(s)
- Kathy L Tsang
- Department of Psychology, University of Calgary, Alberta, Canada
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Abstract
This article summarizes a network and complex systems science model for research on whole systems of complementary and alternative medicine (CAM) such as homeopathy and traditional Chinese medicine. The holistic concepts of networks and nonlinear dynamical complex systems are well matched to the global and interactive perspectives of whole systems of CAM, whereas the reductionistic science model is well matched to the isolated local organ, cell, and molecular mechanistic perspectives of pharmaceutically based biomedicine. Whole systems of CAM are not drugs with specific actions. The diagnostic and therapeutic approaches of whole systems of CAM produce effects that involve global and patterned shifts across multiple subsystems of the person as a whole. For homeopathy, several characteristics of complex systems, including the probabilistic nature of attractor patterns, variable sensitivity of complex systems to initial conditions, and emergent behaviors in the evolution of a system in its full environmental context over time, could help account for the mixed basic science and controlled clinical trial research findings, in contrast with the consistently positive outcomes of observational studies in the literature. Application of theories and methods from complex systems and network science can open a new era of advances in understanding factors that lead to good versus poor individual global outcome patterns and to rational triage of patients to one type of care over another. The growing reliance on complex systems thinking and systems biology for cancer research affords a unique opportunity to bridge between the CAM and conventional medical worlds with some common language and conceptual models.
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Affiliation(s)
- Iris R Bell
- Department of Family, Program in Integrative Medicine, University of Arizona College of Medicine, Tucson, AZ 85719, USA.
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Duberg A, Möller M, Sunvisson H. "I feel free": Experiences of a dance intervention for adolescent girls with internalizing problems. Int J Qual Stud Health Well-being 2016; 11:31946. [PMID: 27416014 PMCID: PMC4944595 DOI: 10.3402/qhw.v11.31946] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/16/2016] [Indexed: 12/18/2022] Open
Abstract
Adolescent girls today suffer from internalizing problems such as somatic symptoms and mental health problems at higher rates compared to those of previous decades, and effective interventions are warranted. The aim of this study was to explore the experiences of participating in an 8-month dance intervention. This qualitative study was embedded in a randomized controlled trial of a dance intervention for adolescent girls with internalizing problems. A total of 112 girls aged 13–18 were included in the study. The dance intervention group comprised 59 girls, 24 of whom were strategically chosen to be interviewed. Data were analyzed using qualitative content analysis with an inductive approach. The experiences of the dance intervention resulted in five generic categories: (1) An Oasis from Stress, which represents the fundamental basis of the intervention; (2) Supportive Togetherness, the setting; (3) Enjoyment and Empowerment, the immediate effect; (4) Finding Acceptance and Trust in Own Ability, the outcome; and (5) Dance as Emotional Expression, the use of the intervention. One main category emerged, Finding Embodied Self-Trust That Opens New Doors, which emphasizes the increased trust in the self and the ability to approach life with a sense of freedom and openness. The central understanding of the adolescent girls’ experiences was that the dance intervention enriched and gave access to personal resources. With the non-judgmental atmosphere and supportive togetherness as a safe platform, the enjoyment and empowerment in dancing gave rise to acceptance, trust in ability, and emotional expression. Taken together, this increased self-trust and they discovered a new ability to “claim space.” Findings from this study may provide practical information on designing future interventions for adolescent girls with internalizing problems.
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Affiliation(s)
- Anna Duberg
- Faculty of Medicine and Health, Örebro University, Örebro, Sweden.,University Healthcare Research Center, Region Örebro County, Örebro, Sweden;
| | - Margareta Möller
- Faculty of Medicine and Health, Örebro University, Örebro, Sweden.,University Healthcare Research Center, Region Örebro County, Örebro, Sweden
| | - Helena Sunvisson
- Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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Piccoli GB, Capizzi I, Vigotti FN, Leone F, D’Alessandro C, Giuffrida D, Nazha M, Roggero S, Colombi N, Mauro G, Castelluccia N, Cupisti A, Avagnina P. Low protein diets in patients with chronic kidney disease: a bridge between mainstream and complementary-alternative medicines? BMC Nephrol 2016; 17:76. [PMID: 27391228 PMCID: PMC4939031 DOI: 10.1186/s12882-016-0275-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 06/14/2016] [Indexed: 01/11/2023] Open
Abstract
Dietary therapy represents an important tool in the management of chronic kidney disease (CKD), mainly through a balanced reduction of protein intake aimed at giving the remnant nephrons in damaged kidneys a "functional rest". While dialysis, transplantation, and pharmacological therapies are usually seen as "high tech" medicine, non pharmacological interventions, including diets, are frequently considered lifestyle-complementary treatments. Diet is one of the oldest CKD treatments, and it is usually considered a part of "mainstream" management. In this narrative review we discuss how the lessons of complementary alternative medicines (CAMs) can be useful for the implementation and study of low-protein diets in CKD. While high tech medicine is mainly prescriptive, prescribing a "good" life-style change is usually not enough and comprehensive counselling is required; the empathic educational approach, on which CAMs are mainly, though not exclusively based, may support a successful personalized nutritional intervention.There is no gold-standard, low-protein diet for all CKD patients: from among a relatively vast choice, the best compliance is probably obtained by personalization. This approach interferes with the traditional RCT-based analyses which are grounded upon an assumption of equal preference of treatments (ideally blinded). Whole system approaches and narrative medicine, that are widely used in the study of CAMs, may offer ways to integrate EBM and personalised medicine in the search for innovative solutions respecting individualization, but gaining sound data, such as with partially-randomised patient preference trials.
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Affiliation(s)
- Giorgina Barbara Piccoli
- />Department of Clinical and Biological Sciences, SS Nephrology, ASOU san Luigi, University of Torino, Torino, Italy
- />Nephrologie, CH du Mans, Le Mans, France
| | - Irene Capizzi
- />Department of Clinical and Biological Sciences, SS Nephrology, ASOU san Luigi, University of Torino, Torino, Italy
- />Nephrologie, CH du Mans, Le Mans, France
| | - Federica Neve Vigotti
- />Department of Clinical and Biological Sciences, SS Nephrology, ASOU san Luigi, University of Torino, Torino, Italy
- />Nephrologie, CH du Mans, Le Mans, France
| | - Filomena Leone
- />Department of Surgery, SS Dietetics, città della salute e della scienza, University of Torino, Torino, Italy
| | - Claudia D’Alessandro
- />Department of Experimental and Clinical Medicine, SCDU Nephrology, University of Pisa, Pisa, Italy
| | - Domenica Giuffrida
- />Department of Surgery, SS Dietetics, città della salute e della scienza, University of Torino, Torino, Italy
| | - Marta Nazha
- />Department of Clinical and Biological Sciences, SS Nephrology, ASOU san Luigi, University of Torino, Torino, Italy
- />Nephrologie, CH du Mans, Le Mans, France
| | - Simona Roggero
- />Department of Clinical and Biological Sciences, SS Nephrology, ASOU san Luigi, University of Torino, Torino, Italy
- />Nephrologie, CH du Mans, Le Mans, France
| | - Nicoletta Colombi
- />Department of Clinical and Biological Sciences and of Oncology, Library, ASOU san Luigi, University of Torino, Torino, Italy
| | - Giuseppe Mauro
- />Department of Clinical and Biological Sciences and of Oncology, Library, ASOU san Luigi, University of Torino, Torino, Italy
| | - Natascia Castelluccia
- />Department of Clinical and Biological Sciences and of Oncology, Library, ASOU san Luigi, University of Torino, Torino, Italy
| | - Adamasco Cupisti
- />Department of Experimental and Clinical Medicine, SCDU Nephrology, University of Pisa, Pisa, Italy
| | - Paolo Avagnina
- />Department of Clinical and Biological Sciences, SSD Clinical Nutrition, ASOU san Luigi, University of Torino, Torino, Italy
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Desrochers P, Kairy D, Pan S, Corriveau H, Tousignant M. Tai chi for upper limb rehabilitation in stroke patients: the patient's perspective. Disabil Rehabil 2016; 39:1313-1319. [PMID: 27347600 DOI: 10.1080/09638288.2016.1194900] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION This study aimed at exploring the perceived benefits and drawbacks of practicing tai chi, an alternative therapy that can be implemented in the community, as part of upper-limb rehabilitation following stroke. METHODOLOGY Semistructured interviews were carried out with participants with chronic stroke (>6 months). The participants took part in 16 tai chi sessions over 8 weeks. Interviews were conducted in person using an interview guide based on the theory of planned behavior (TPB), and a thematic analysis was conducted. RESULTS Eight interviews were carried out with participants at various stages of motor recovery. Participants perceived a number of physical, functional, and psychological benefits. They found tai chi to be a global exercise, including both physical and mental aspects, and suggested that it can be included as part of rehabilitation for stroke patients. Many participants expressed a desire to continue practicing tai chi after completion of the study because it exceeded their expectations, among other reasons. CONCLUSION This study can serve to guide future tai chi interventions and research on tai chi for rehabilitation in terms of the characteristics of the intervention and the various areas to assess in order to measure the overall benefits. IMPLICATIONS FOR REHABILITATION Tai chi was perceived as a good way of integrating various skills learned during rehabilitation. Despite having different functional abilities, all the participants noted various physical, functional, and psychological benefits from participating in the tai chi sessions. Tai chi seems to be a form of exercise that stroke patients would perform more long-term since all the participants in this study expressed the desire to continue practicing tai chi.
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Affiliation(s)
- Pascal Desrochers
- a School of Rehabilitation, Université de Montréal , Montreal , Quebec , Canada
| | - Dahlia Kairy
- a School of Rehabilitation, Université de Montréal , Montreal , Quebec , Canada.,b Center for Interdisciplinary Research in Rehabilitation of Greater Montreal - IRGLM Site , Montreal , Quebec , Canada
| | - Shujuan Pan
- a School of Rehabilitation, Université de Montréal , Montreal , Quebec , Canada
| | - Hélène Corriveau
- c School of Rehabilitation, Université de Sherbrooke , Sherbrooke , QC , Canada.,d Research Center on Aging, University Institute of Geriatrics of Sherbrooke , Sherbrooke , QC , Canada
| | - Michel Tousignant
- c School of Rehabilitation, Université de Sherbrooke , Sherbrooke , QC , Canada.,d Research Center on Aging, University Institute of Geriatrics of Sherbrooke , Sherbrooke , QC , Canada
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Kim Y, Shin HY, Moon W, Cho SH. Use of complementary and alternative medicine by lung cancer patients in Korea: A qualitative study. Eur J Integr Med 2016. [DOI: 10.1016/j.eujim.2015.12.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Marquer C, Grais RF, Moro MR. Maternal perception of emotional difficulties of preschool children in rural Niger. Transcult Psychiatry 2016; 53:330-46. [PMID: 27235143 DOI: 10.1177/1363461516645046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Mental health care for infants and young children is often greatly limited in low-resource settings. The purpose of this study was to describe maternal perception of emotional difficulties of preschool children in a rural area of Niger (Maradi). In this context, both mental health awareness and services were scarce. This research was part of a larger cross-cultural validation study of a screening tool for psychological difficulties in children aged 3 to 6 years old. Data collection included group discussion and individual interviews. A total of 10 group interviews and 83 individual interviews were conducted. The results highlight mothers' perceptions concerning their children's psychological difficulties. Sleep difficulties were considered significant by the mothers and were used often as an entry point for further discussion of concerns. Peer and sibling relationships, separation anxiety, and reactions to difficult events were also described. Identification of mothers' perceptions of children's main difficulties through a mixed-method approach shows promise as a way to inform interventions to provide culturally appropriate care for children in need.
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Yeh GY, Chan CW, Wayne PM, Conboy L. The Impact of Tai Chi Exercise on Self-Efficacy, Social Support, and Empowerment in Heart Failure: Insights from a Qualitative Sub-Study from a Randomized Controlled Trial. PLoS One 2016; 11:e0154678. [PMID: 27177041 PMCID: PMC4866692 DOI: 10.1371/journal.pone.0154678] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 04/18/2016] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To qualitatively explore perceived physical and psychosocial effects and overall patient experience associated with a 12-week tai chi (TC) intervention and an education group in a clinical trial of patients with chronic heart failure (HF). SUBJECTS AND METHODS We randomized 100 patients with chronic systolic HF (NYHA Class 1-3, ejection fraction≤40%) to a 12-week group TC program or an education control. At 12-weeks, semi-structured interviews were conducted on a random subset (n = 32; n = 17 in TC, n = 15 in control), audiorecorded and transcribed verbatim. Two independent reviewers extracted information using grounded-theory methods for emergent themes. We explored similarities and differences in themes/sub-themes between the groups, and examined qualitative association with changes from baseline to post-intervention in previously reported quantitative measures (e.g., Minnesota Living with HF, Cardiac Exercise Self Efficacy and Profile of Mood States). RESULTS The mean age (±SD) of participants was 68±9 years, baseline ejection fraction 29±7%, and median New York Heart Association class 2 HF. We idenitifed themes related to the patient's experience of illness, perceptions of self, and relationship to others. Specific psychosocial and physical benefits were described. Common themes emerged from both groups including: social support and self-efficacy related to activity/exercise and diet. The tai chi group, however, also exhibited a more global empowerment and perceived control. Additional themes in TC included mindfulness/self-awareness, decreased stress reactivity, and renewed social role. These themes mirrored improvements in previously reported quantitative measures (quality-of-life, self-efficacy, and mood) in TC compared to control. Patients in TC also reported physical benefits (e.g., decreased pain, improved energy, endurance, flexibility). CONCLUSION Positive themes emerged from both groups, although there were qualitative differences in concepts of self-efficacy and perceived control between groups. Those in tai chi reported not only self efficacy and social support, but overall empowerment with additional gains such as internal locus of control, self-awareness and stress management. Future studies of mind-body exercise might further examine perceived control, self-efficacy, and locus-of-control as potential mediators of effect.
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Affiliation(s)
- Gloria Y. Yeh
- Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States of America
| | - Caroline W. Chan
- Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States of America
| | - Peter M. Wayne
- Osher Center for Integrative Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
- Division of Preventive Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
| | - Lisa Conboy
- New England School of Acupuncture, Boston, Massachusetts, United States of America
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Ooi SL, Rae J, Pak SC. Implementation of evidence-based practice: A naturopath perspective. Complement Ther Clin Pract 2016; 22:24-8. [DOI: 10.1016/j.ctcp.2015.11.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 11/26/2015] [Indexed: 10/22/2022]
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Warber SL, Bruyere RL, Weintrub K, Dieppe P. A Consideration of the Perspectives of Healing Practitioners on Research Into Energy Healing. Glob Adv Health Med 2015; 4:72-8. [PMID: 26665045 PMCID: PMC4654782 DOI: 10.7453/gahmj.2015.014.suppl] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Energy healing is a complex intervention with the purpose of enhancing wholeness within the client. Approaches to complex interventions require thoughtful utilization of a wide range of research methods. In order to advance the research in this field, we sought to understand the healing practitioners' point of view by reviewing qualitative literature, research reviews, and commentary written by and about practitioners. Further, we conducted a brief survey among healers, asking their opinions on types and topics of research in this field. Emerging from this inquiry is an overview of the healers' state required for successful healing, the importance of the clients' contribution, the heterogeneity of the process of healing, and the importance of choosing appropriate outcomes to reflect the goal of wholeness. Beyond attending to measurement of these nuanced aspects, we propose utilization of research designs appropriate for complex interventions, more use of qualitative research techniques, consideration of large data registries, and adoption of the perspectives of realist research. An important gap identified was the overall lack of understanding of the clients' experience and contribution to the healing encounter.
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Affiliation(s)
- Sara L Warber
- University of Michigan, Department of Family Medicine, Ann Arbor (Dr Warber)
| | | | | | - Paul Dieppe
- University of Exeter Medical School, Institute of Health Research, United Kingdom (Dr Dieppe)
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Embong NH, Soh YC, Ming LC, Wong TW. Revisiting reflexology: Concept, evidence, current practice, and practitioner training. J Tradit Complement Med 2015; 5:197-206. [PMID: 26587391 PMCID: PMC4624523 DOI: 10.1016/j.jtcme.2015.08.008] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2015] [Revised: 08/16/2015] [Accepted: 08/20/2015] [Indexed: 11/20/2022] Open
Abstract
Reflexology is basically a study of how one part of the human body relates to another part of the body. Reflexology practitioners rely on the reflexes map of the feet and hands to all the internal organs and other human body parts. They believe that by applying the appropriate pressure and massage certain spots on the feet and hands, all other body parts could be energized and rejuvenated. This review aimed to revisit the concept of reflexology and examine its effectiveness, practices, and the training for reflexology practitioners. PubMed, SCOPUS, Google Scholar, and SpringerLink databases were utilized to search the following medical subject headings or keywords: foot massage, reflexology, foot reflexotherapy, reflexological treatment, and zone therapy. The articles published for the last 10 years were included. Previous systematic reviews failed to show concrete evidence for any specific effect of reflexology in any conditions. Due to its non-invasive, non-pharmacological complementary nature, reflexology is widely accepted and anecdotal evidence of positive effect reflexology in a variety of health conditions are available. Adequate training for practitioners is necessary to ensure the consistency of service provided.
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Affiliation(s)
| | - Yee Chang Soh
- Faculty of Pharmacy, Universiti Teknologi MARA, Puncak Alam, Selangor, Malaysia
| | - Long Chiau Ming
- Faculty of Pharmacy, Universiti Teknologi MARA, Puncak Alam, Selangor, Malaysia
- Brain Degeneration and Therapeutics Group, Pharmaceutical and Life Sciences CoRe, Universiti Teknologi MARA, Shah Alam, Selangor, Malaysia
| | - Tin Wui Wong
- Non-Destructive Biomedical and Pharmaceutical Research Centre, iPROMISE, Universiti Teknologi MARA, Puncak Alam, Selangor, Malaysia
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Lindström C, Åman J, Anderzén-Carlsson A, Lindahl Norberg A. Group intervention for burnout in parents of chronically ill children - a small-scale study. Scand J Caring Sci 2015; 30:678-686. [PMID: 26395446 DOI: 10.1111/scs.12287] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 08/05/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Long-term stress leading to burnout symptoms is prevalent in parents of chronically ill children. The aim of the study was to evaluate the effect of a group intervention by measuring changes in self-rated clinical burnout and performance-based self-esteem. In addition, the parental perceptions of the acceptability of the intervention were explored. METHODS Previously, we have explored the prevalence of clinical burnout in parents of patients 1-18 years with type 1 diabetes mellitus (T1DM) and inflammatory bowel disease (IBD) in the county of Örebro. All parents who exhibited clinical burnout symptoms in accordance with the Shirom-Melamed Burnout Questionnaire (SMBQ) were then invited to participate in a group intervention, which was evaluated in the present small-scale study. The group intervention consisted of eight sessions over a 12-week period, including education about behaviour, cognition and symptoms associated with burnout, intending to help the parents to develop adequate strategies for coping with and reducing stress. We evaluated the effect of the intervention in terms of self-rated clinical burnout and performance-based self-esteem (PBSE). In addition, the acceptability of the intervention was evaluated by analyses of recruitment and retention and self-reports from parents. RESULTS Sixteen parents (13 of children with TIDM and three of children with IBD) out of 104 reporting clinical burnout participated in the intervention. All participants completed the intervention, and the mean attendance rate at all sessions was 90%. Parents' subjective evaluations were mainly positive, and SMBQ (p = 0.01) and PBSE scale (p = 0.04) measurements were significantly reduced, which effects remained 6 months after completion of the intervention. CONCLUSIONS Despite the small-scale study, we consider that this intervention for parents with clinical burnout was appreciated and well accepted. The significant reduction in clinical burnout symptoms requires further evaluation in randomised controlled studies based on larger groups of parents.
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Affiliation(s)
- Caisa Lindström
- Department of Pediatrics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.,School of Health and Medical Sciences, Örebro University, Örebro, Sweden
| | - Jan Åman
- Department of Pediatrics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.,School of Health and Medical Sciences, Örebro University, Örebro, Sweden
| | - Agneta Anderzén-Carlsson
- Centre for Health Care Science, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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Use of pragmatic community-based interventions to enhance recruitment and adherence in a randomized trial of Tai Chi for women with osteopenia: insights from a qualitative substudy. Menopause 2015; 21:1181-9. [PMID: 24845395 DOI: 10.1097/gme.0000000000000257] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aims to qualitatively evaluate the feasibility of using a pragmatic network of community-based Tai Chi schools to deliver 9-month exercise interventions to women with osteopenia and to explore the impact of this design feature on facilitators and barriers to trial recruitment and participant adherence during and after the trial. METHODS In a randomized trial comparing 9 months of Tai Chi plus usual care with usual care alone for postmenopausal women with moderately low bone mass, exit interviews were conducted with 43 participants randomized to the pragmatically delivered Tai Chi intervention. Transcripts were digitially recorded, transcribed, and imported into NVivo, a computer-assisted qualitative data analysis software. Qualitative content analysis was used to code the data. Patterns emerging from among the codes were further examined and clustered into themes. RESULTS Analyses revealed features of pragmatically delivered Tai Chi programs that both facilitated and impeded study participation and/or posttrial adherence. Direct facilitators included convenience of class locations and times, alternative learning modalities, quality of teaching, community and social support, and perceived health benefits. Barriers consisted primarily of time-related issues. A possible causal mechanism (self-efficacy) was also identified. CONCLUSIONS Factors related to the use of pragmatically delivered interventions are beneficial for fostering both study participation and posttrial adherence to the Tai Chi programs. This qualitative substudy is valuable for identifying these factors and a possible causal mechanism. These findings will assist in the design and conduct of future studies exploring the use of Tai Chi in fracture prevention and health-related quality of life in postmenopausal women.
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Thompson JJ, Nichter M. Is There a Role for Complementary and Alternative Medicine in Preventive and Promotive Health? An Anthropological Assessment in the Context of U.S. Health Reform. Med Anthropol Q 2015; 30:80-99. [PMID: 25316618 DOI: 10.1111/maq.12153] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Chronic conditions associated with lifestyle and modifiable behaviors are the leading causes of morbidity and mortality in the United States. The implementation of the Affordable Care Act offers an historic opportunity to consider novel approaches to addressing the nation's public health concerns. We adopt an anticipatory anthropological perspective to consider lifestyle behavior change as common ground shared by practitioners of both biomedicine and common forms of complementary and alternative medicine (CAM). At issue is whether CAM practitioners might play a more proactive and publicly endorsed role in delivering preventive and promotive health services to address these needs. Recognizing that this is a contentious issue, we consider two constructive roles for engaged medical anthropologists: (1) as culture brokers helping to facilitate interprofessional communities of preventive and promotive health practice and (2) in collaboration with health service researchers developing patient-near evaluations of preventive and promotive health services on patient well-being and behavior change.
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Affiliation(s)
- Jennifer Jo Thompson
- Department of Crop and Soil Sciences, Department of Anthropology, University of Georgia.
| | - Mark Nichter
- School of Anthropology, Department of Family and Community Medicine, School of Public Health, University of Arizona
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Marquer C, Barry C, Mouchenik Y, Djibo DM, Manzo ML, Trujillo Maza EM, Githaiga S, Casas G, Kirubi BW, Marichez H, Falissard B, Moro MR, Grais RF. Screening for psychological difficulties in young children in crisis: complementary cross-cultural validation. Int Health 2015; 7:438-46. [PMID: 25740941 DOI: 10.1093/inthealth/ihv006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Accepted: 10/08/2014] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Detection of children's psychological difficulties in crises and low resource settings is challenged by the lack of a validated, rapid and simple tool. We present the results of two confirmatory validations of the Psychological Screening for Young Children aged 3 to 6 years (PSYCa 3-6) scale. METHODS We performed cross-cultural validations, assessing the performance of the scale in different contexts. These were conducted in Mathare, Nairobi, Kenya and Buenaventura, Colombia between December 2009 and February 2012. External validity was assessed comparing the PSYCa 3-6 against a clinical interview and the Clinical Global Impression Severity scale (CGI). RESULTS A total of 160 mothers or caregivers of children 3 to 6 years old in Mathare and 148 in Buenaventura were included in the study. Both demonstrated good concurrent validity (Buenaventura ρ=0.49, p<0.0001; Mathare ρ=0.41, p<0.0001). Inter-rater reliability was found to be acceptable in Buenaventura (intraclass correlation [ICC]=0.69 [0.4-0.84]) and high in Mathare (0.87 [0.75-0.94]). CONCLUSIONS As shown by its validation in diverse contexts, use in other populations may help improve the delivery of mental health care to children in crises and low-resource settings. Additional research on the design and delivery of intervention models for crises remains essential.
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Affiliation(s)
- Caroline Marquer
- Epicentre, Nairobi, Kenya Laboratoire de Psychologie Clinique et Psychopathologie (EA 4056), Université Paris Descartes, Sorbonne Paris Cité, Institut de Psychologie, Paris, France
| | - Caroline Barry
- Laboratoire de Psychologie Clinique et Psychopathologie (EA 4056), Université Paris Descartes, Sorbonne Paris Cité, Institut de Psychologie, Paris, France
| | - Yoram Mouchenik
- Université Paris-Sud et Université Paris Descartes, Inserm U669, Paris, France Université Paris 13, Centre Hospitalier Sainte-Anne, Paris Université Paris 13, Sorbonne Paris Cité, Inserm U669, AP-HP, Bobigny, France
| | | | - Mahamane L Manzo
- National Mental Health Program, Ministry of Health, Niamey, Niger
| | | | | | - German Casas
- Regional Department of Public Health, Maradi, Niger
| | | | | | - Bruno Falissard
- Laboratoire de Psychologie Clinique et Psychopathologie (EA 4056), Université Paris Descartes, Sorbonne Paris Cité, Institut de Psychologie, Paris, France
| | - Marie-Rose Moro
- Laboratoire de Psychologie Clinique et Psychopathologie (EA 4056), Université Paris Descartes, Sorbonne Paris Cité, Institut de Psychologie, Paris, France Médecins Sans Frontières, Paris, France Université Paris Descartes, Sorbonne Paris Cité, Hôpital Cochin, Assistance Publique Hôpitaux de Paris, France
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Archer S, Phillips E, Montague J, Bali A, Sowter H. "I'm 100% for it! I'm a convert!": women's experiences of a yoga programme during treatment for gynaecological cancer; an interpretative phenomenological analysis. Complement Ther Med 2014; 23:55-62. [PMID: 25637153 DOI: 10.1016/j.ctim.2014.12.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2014] [Revised: 11/25/2014] [Accepted: 12/17/2014] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES To explore patients' experiences of taking part in a yoga intervention while undergoing treatment for gynaecological cancer. DESIGN Sixteen women (age range 31-79 years; mean age 60) participated in focus groups based on a semi-structured question schedule. Resulting discussions were audio-recorded, transcribed verbatim and analysed using interpretative phenomenological analysis (IPA). SETTING Royal Derby Hospital, UK. INTERVENTIONS Patients took part in a 10-week course of Hatha yoga, where they participated in a one hour long class per week. RESULTS Three themes emerged from the data: applying breathing techniques, engaging in the physicality of yoga and finding a community. The first theme was particularly important to the patients as they noted the breadth and applicability of the techniques in their day-to-day lives. The latter two themes reflect physical and social perspectives, which are established topics in the cancer and yoga literature and are contextualised here within the women's experiences of cancer treatment. CONCLUSIONS The women's perceptions of the programme were generally positive, providing a previously unseen view of the patient experience of participating in a yoga intervention. The difference between the women's prior expectations and lived experiences is discussed.
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Affiliation(s)
- S Archer
- Centre for Patient Safety and Service Quality, Imperial College London, Medical School Building, St Mary's Campus Norfolk Place, London W2 1PG, United Kingdom.
| | - E Phillips
- Psychology, University of Derby Online Learning, University of Derby, Kedleston Road, Derby DE22 1GB, United Kingdom.
| | - J Montague
- Psychology, Department of Life Sciences, University of Derby, Kedleston Road, Derby DE22 1GB, United Kingdom.
| | - A Bali
- Royal Derby Hospital, Uttoxeter New Road, Derby DE22 3NE, United Kingdom.
| | - H Sowter
- Biomedical Science and Public Health, Department of Life Sciences, University of Derby, Kedleston Road, Derby DE22 1GB, United Kingdom.
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Stoewen DL, Coe JB, MacMartin C, Stone EA, Dewey CE. Qualitative study of the information expectations of clients accessing oncology care at a tertiary referral center for dogs with life-limiting cancer. J Am Vet Med Assoc 2014; 245:773-83. [DOI: 10.2460/javma.245.7.773] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Fischer HF, Junne F, Witt C, von Ammon K, Cardini F, Fønnebø V, Johannessen H, Lewith G, Uehleke B, Weidenhammer W, Brinkhaus B. Key issues in clinical and epidemiological research in complementary and alternative medicine--a systematic literature review. ACTA ACUST UNITED AC 2014; 19 Suppl 2:51-60. [PMID: 23883945 DOI: 10.1159/000343126] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND In the last 2 decades there has been a large increase in publications on complementary and alternative medicine (CAM). However, CAM research methodology was heterogeneous and often of low quality. The aim of this systematic review was to investigate scientific publications with regards to general issues, concepts and strategies. We also looked at research priorities and methods employed to evaluate the clinical and epidemiological research of CAM in the past to identify the basis for consensus-based research strategies. METHODS We performed a systematic literature search for papers published between 1990 and 2010 in 7 electronic databases (Medline, Web of Science, PsychArticles, PsycInfo, CINAHL, EMBASE and Cochrane Library) on December 16 and 17, 2010. In addition, experts were asked to nominate relevant papers. Inclusion criteria were publications dealing with research methodology, priorities or complexities in the scientific evaluation of CAM. All references were assessed in a multistage process to identify relevant papers. RESULTS From the 3,279 references derived from the search and 98 references contributed by CAM experts, 170 papers fulfilled the criteria and were included in the analysis. The following key issues were identified: difficulties in past CAM research (e.g., randomisation, blinding), utility of quantitative and qualitative research methods in CAM, priority setting in CAM research and specific issues regarding various CAM modalities. CONCLUSIONS Most authors vote for the use of commonly accepted research methods to evaluate CAM. There was broad consensus that a mixed methods approach is the most suitable for gathering conclusive knowledge about CAM.
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Affiliation(s)
- H Felix Fischer
- Institute for Social Medicine, Epidemiology and Health Economics, Charité University Medical Center, Berlin, Germany.
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Holmberg C, Karner JJ, Rappenecker J, Witt CM. Clinical trial participants' experiences of completing questionnaires: a qualitative study. BMJ Open 2014; 4:e004363. [PMID: 24662446 PMCID: PMC3975744 DOI: 10.1136/bmjopen-2013-004363] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To improve clinical study developments for elderly populations, we aim to understand how they transfer their experiences into validated, standardised self-completed study measurement instruments. We analysed how women (mean 78±8 years of age) participating in a randomised controlled trial (RCT) cognised study instruments used to evaluate outcomes of the intervention. SETTING The interview study was nested in an RCT on chronic neck pain using common measurement instruments situated in an elderly community in Berlin, Germany, which comprised of units for independent and assisted-living options. PARTICIPANTS The sample (n=20 women) was selected from the RCT sample (n=117, 95% women, mean age 76 (SD±8) years). Interview participants were selected using a purposive sampling list based on the RCT outcomes. OUTCOMES We asked participants about their experiences completing the RCT questionnaires. Interviews were analysed thematically, then compared with the questionnaires. RESULTS Interviewees had difficulties in translating complex experiences into a single value on a scale and understanding the relationship of the questionnaires to study aims. Interviewees considered important for the trial that their actual experiences were understood by trial organisers. This information was not transferrable by means of the questionnaires. To rectify these difficulties, interviewees used strategies such as adding notes, adding response categories or skipping an item. CONCLUSIONS Elderly interview participants understood the importance of completing questionnaires for trial success. This led to strategies of completing the questionnaires that resulted in 'missing' or ambiguous data. To improve data collection in elderly populations, educational materials addressing the differential logics should be developed and tested. Pilot testing validated instruments using cognitive interviews may be particularly important in such populations. Finally, when the target of an intervention is a subjective experience, it seems important to create a method by which participants can convey their personal experiences. These could be nested qualitative studies. TRIAL REGISTRATION NUMBER ISRCTN77108101807.
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Affiliation(s)
- Christine Holmberg
- Institute for Social Medicine, Epidemiology, and Health Economics, Charité Universitätsmedizin Berlin, Berlin, Germany
- Berlin School of Public Health, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Julia J Karner
- Institute for Social Medicine, Epidemiology, and Health Economics, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Julia Rappenecker
- Institute for Social Medicine, Epidemiology, and Health Economics, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Claudia M Witt
- Institute for Social Medicine, Epidemiology, and Health Economics, Charité Universitätsmedizin Berlin, Berlin, Germany
- Institute of Complementary and Integrative Medicine, University Hospital Zürich, Zürich, Switzerland
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Anderzén-Carlsson A, Persson Lundholm U, Köhn M, Westerdahl E. Medical yoga: another way of being in the world-a phenomenological study from the perspective of persons suffering from stress-related symptoms. Int J Qual Stud Health Well-being 2014; 9:23033. [PMID: 24434055 PMCID: PMC3888904 DOI: 10.3402/qhw.v9.23033] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/02/2013] [Indexed: 11/14/2022] Open
Abstract
The prevalence of stress-related illness has grown in recent years. Many of these patients seek help in primary health care. Yoga can reduce stress and thus complements pharmacological therapy in medical practice. To our knowledge, no studies have investigated patients' experiences of yoga treatment in a primary health care setting or, specifically, the experiences of yoga when suffering from stress-related illness. Thus, the aim of the present study was to explore the meaning of participating in medical yoga as a complementary treatment for stress-related symptoms and diagnosis in a primary health care setting. This study has a descriptive phenomenological design and took place at a primary health care centre in Sweden during 2011. Five women and one man (43-51 years) participated. They were recruited from the intervention group (n=18) in a randomized control trial, in which they had participated in a medical yoga group in addition to standard care for 12 weeks. Data were collected by means of qualitative interviews, and a phenomenological data analysis was conducted. The essential meaning of the medical yoga experience was that the medical yoga was not an endpoint of recovery but the start of a process towards an increased sense of wholeness. It was described as a way of alleviating suffering, and it provided the participants with a tool for dealing with their stress and current situation on a practical level. It led to greater self-awareness and self-esteem, which in turn had an implicit impact on their lifeworld. In phenomenological terms, this can be summarized as Another way of being in the world, encompassing a perception of deepened identity. From a philosophical perspective, due to using the body in a new way (yoga), the participants had learnt to see things differently, which enriched and recast their perception of themselves and their lives.
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Affiliation(s)
| | | | - Monica Köhn
- Nora Health Care Centre, Örebro County Council, Nora, Sweden
| | - Elisabeth Westerdahl
- Centre for Health Care Sciences, Örebro University Hospital, Örebro, Sweden; School of Health and Medical Sciences, Örebro University, Örebro, Sweden
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Mixed Methods in CAM Research: A Systematic Review of Studies Published in 2012. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2013:187365. [PMID: 24454489 PMCID: PMC3881584 DOI: 10.1155/2013/187365] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2013] [Accepted: 10/20/2013] [Indexed: 02/03/2023]
Abstract
Background. Mixed methods research uses qualitative and quantitative methods together in a single study or a series of related studies. Objectives. To review the prevalence and quality of mixed methods studies in complementary medicine. Methods. All studies published in the top 10 integrative and complementary medicine journals in 2012 were screened. The quality of mixed methods studies was appraised using a published tool designed for mixed methods studies. Results. 4% of papers (95 out of 2349) reported mixed methods studies, 80 of which met criteria for applying the quality appraisal tool. The most popular formal mixed methods design was triangulation (used by 74% of studies), followed by embedded (14%), sequential explanatory (8%), and finally sequential exploratory (5%). Quantitative components were generally of higher quality than qualitative components; when quantitative components involved RCTs they were of particularly high quality. Common methodological limitations were identified. Most strikingly, none of the 80 mixed methods studies addressed the philosophical tensions inherent in mixing qualitative and quantitative methods. Conclusions and Implications. The quality of mixed methods research in CAM can be enhanced by addressing philosophical tensions and improving reporting of (a) analytic methods and reflexivity (in qualitative components) and (b) sampling and recruitment-related procedures (in all components).
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Smith JM, John Sullivan S, David Baxter G. Complementary and alternative medicine: contemporary trends and issues. PHYSICAL THERAPY REVIEWS 2013. [DOI: 10.1179/1743288x11y.0000000013] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Sibbritt DW, Catling CJ, Adams J, Shaw AJ, Homer CSE. The self-prescribed use of aromatherapy oils by pregnant women. Women Birth 2013; 27:41-5. [PMID: 24670414 DOI: 10.1016/j.wombi.2013.09.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Revised: 08/02/2013] [Accepted: 09/26/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND While some studies have reported effectiveness of aromatherapy oils use during labour there is no reported evidence of efficacy or risks of aromatherapy oils use for pregnancy-related symptoms or conditions. A number of aromatherapy oils are unsafe for use by pregnant women yet there is currently no research examining the prevalence and characteristics of women who use aromatherapy oils during pregnancy. AIM To conduct an empirical study of the prevalence and characteristics of women who use aromatherapy oils during pregnancy. METHODS The research was conducted as part of the Australian Longitudinal Study on Women's Health (ALSWH), focusing on the nationally representative sample of Australian women aged 31-36 years. Data were collected via a cross-sectional questionnaire (n=8200) conducted in 2009. RESULTS Self-prescribed aromatherapy oils were used by 15.2% of pregnant women. Pregnant women were 1.57 (95% CI: 1.01, 2.43) times more likely to self-prescribe use of aromatherapy oils if they have allergies or hayfever, and 2.26 (95% CI: 1.34, 3.79) times more likely to self-prescribe use of aromatherapy oils if they have a urinary tract infection (UTI). CONCLUSION Our study highlights a considerable use of aromatherapy oils by pregnant women. There is a clear need for greater communication between practitioners and patients regarding the use of aromatherapy oils during pregnancy, as well a need for health care practitioners to be mindful that pregnant women in their care may be using aromatherapy oils, some of which may be unsafe.
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Affiliation(s)
- David W Sibbritt
- Faculty of Health, University of Technology Sydney, PO Box 123, Broadway, NSW 2007, Australia.
| | - Christine J Catling
- Faculty of Health, University of Technology Sydney, PO Box 123, Broadway, NSW 2007, Australia.
| | - Jon Adams
- Faculty of Health, University of Technology Sydney, PO Box 123, Broadway, NSW 2007, Australia.
| | - Andrea J Shaw
- The Royal Hospital for Women in Randwick, Barker Street, Randwick, NSW 2031, Australia.
| | - Caroline S E Homer
- Faculty of Health, University of Technology Sydney, PO Box 123, Broadway, NSW 2007, Australia.
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