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Morgan SP, Lengacher CA, Seo Y. A Systematic Review of Breathing Exercise Interventions: An Integrative Complementary Approach for Anxiety and Stress in Adult Populations. J Holist Nurs 2024:8980101241273860. [PMID: 39150318 DOI: 10.1177/08980101241273860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2024]
Abstract
Aim: Nurses are well-qualified to deliver integrative complementary therapy interventions, a holistic approach to assist individuals experiencing anxiety and stress. Self-regulated, controlled breathing exercises (a clinical approach) are reported to decrease anxiety and increase stress tolerance. The aim of this systematic review was to evaluate the effectiveness of breathing exercise interventions on the psychological and physiologic outcomes of anxiety and stress among adults and assess the state of the science in the post-COVID-19 population. Methods: A systematic review was conducted, and four scientific databases were searched: PubMed, CINAHL, EMBASE, and Web of Science. Inclusion criteria included: (1) peer-reviewed studies, (2) adults over 18, (3) breathing exercise interventions, and (4) anxiety or stress as outcomes. Results: Out of 309 studies identified, 19 were included. Twelve reported significant improvements in anxiety and nine reported significant improvements in stress following varying breathing exercise interventions (p < .05). No adverse events were reported. Conclusions: Breathing exercises were found to be effective in reducing anxiety and stress in adults, however, there continues to be limited evidence that includes large randomized controlled trials. Breathing exercises are a holistic care approach that can be safely implemented by nurses to decrease symptomatology among adults, including the post-COVID population.
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Affiliation(s)
- Sandra P Morgan
- College of Nursing, University of South Florida, Tampa, FL, USA
| | | | - Yaewon Seo
- College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX, USA
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Lai CY, Lin CH, Chao TC, Lin CH, Chang CC, Huang CY, Chiang SL. Effectiveness of a 12-week telerehabilitation training in people with long COVID: A randomized controlled trial. Ann Phys Rehabil Med 2024; 67:101853. [PMID: 38824899 DOI: 10.1016/j.rehab.2024.101853] [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: 10/06/2023] [Revised: 04/09/2024] [Accepted: 04/14/2024] [Indexed: 06/04/2024]
Abstract
BACKGROUND Telerehabilitation has been developed and applied for years for cardiac and pulmonary diseases with good clinical outcomes. However, its application to participants with long COVID remains limited. OBJECTIVES To investigate the effectiveness of a 12-week telerehabilitation training program in participants with long COVID. The primary outcome was cardiorespiratory fitness (CRF), and secondary outcomes were physical activity (PA) amounts, exercise self-efficacy, sleep quality, and health-related quality of life (HRQOL). METHODS A parallel-group, randomized controlled trial was conducted. Eligible participants with long COVID (n = 182) were randomly assigned in a 1:1 ratio to either the experimental group (EG) or the control group (CG). The EG received 12 weeks of telerehabilitation training with weekly remote monitoring for exercise maintenance and support. The CG received PA counseling only. CRF, PA amounts, exercise self-efficacy, sleep quality, and HRQOL were assessed at baseline and 12 weeks. Generalized estimating equations were used to analyze the intervention effects by examining the interaction between time and group. RESULTS One hundred twenty-two participants (67 %) completed the study, and 182 were included in the intention-to-treat analysis. The EG had greater walking behavior (β = -763.3, p < 0.001), total amount of PA (β= -711, p = 0.003), exercise self-efficacy (β = -1.19, p < 0.001), and better sleep quality (β = 1.69, p = 0.012) after the 12-weeks of telerehabilitation training than the CG. However, there were no significant differences in any CRF parameters or HRQOL at 12 weeks between the EG and CG. CONCLUSION Telerehabilitation training offers a personalized and convenient approach that can increase exercise willingness and PA amounts and improve sleep quality. These findings underscore the potential benefits of telerehabilitation training for promoting healthier lifestyles and improving overall health outcomes. CLINICAL TRIAL REGISTRATION The study was registered at ClinicalTrials.gov (NCT05205460) on January 25, 2022.
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Affiliation(s)
- Chia-Ying Lai
- Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Chia-Huei Lin
- School of Nursing & School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Ta-Chung Chao
- Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Chueh-Ho Lin
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Taiwan
| | - Cheng-Chiang Chang
- Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Chien-Yao Huang
- Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Shang-Lin Chiang
- Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.
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Daniels K, Mourad J, Bonnechère B. Exploring the Use of Mobile Health for the Rehabilitation of Long COVID Patients: A Scoping Review. Healthcare (Basel) 2024; 12:451. [PMID: 38391826 PMCID: PMC10887561 DOI: 10.3390/healthcare12040451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 02/05/2024] [Accepted: 02/08/2024] [Indexed: 02/24/2024] Open
Abstract
The COVID-19 pandemic has led to a substantial revolution in the incorporation of digital solutions in healthcare. This systematic review investigates the enduring physical and psychological consequences individuals experience up to two years post-recovery. Additionally, it focuses on examining the influence of mHealth interventions on these effects. Significantly, 41.7% of survivors experience lingering symptoms that have not been addressed, while 14.1% encounter difficulties in returning to work. The presence of anxiety, compromised respiratory functioning, and persistent symptoms highlight the immediate requirement for specific therapies. Telehealth, particularly telerehabilitation, presents itself as a possible way to address these difficulties. The study thoroughly examines 10 studies encompassing 749 COVID-19 patients, investigating the efficacy of telerehabilitation therapies in addressing various health markers. Telerehabilitation-based breathing exercises yield substantial enhancements in functional performance, dyspnea, and overall well-being. The results emphasize the potential of telerehabilitation to have a favorable effect on patient outcomes; however, more research is needed to strengthen the existing evidence base, as one of the most important limitations is the limited number of trials and the evaluation of varied therapies. This analysis highlights the significance of digital solutions in post-COVID care and calls for ongoing research to improve the comprehension and implementation of telehealth interventions in a swiftly changing healthcare environment.
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Affiliation(s)
- Kim Daniels
- Department of PXL-Healthcare, PXL University of Applied Sciences and Arts, 3500 Hasselt, Belgium
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium
| | - Joanna Mourad
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium
| | - Bruno Bonnechère
- Department of PXL-Healthcare, PXL University of Applied Sciences and Arts, 3500 Hasselt, Belgium
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium
- Technology-Supported and Data-Driven Rehabilitation, Data Sciences Institute, Hasselt University, 3590 Diepenbeek, Belgium
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Crawford MJ, King JD, McQuaid A, Bassett P, Leeson VC, Tella O, Di Simplicio M, Tyrer P, Tyrer H, Watt RG, Barnicot K. Severe COVID anxiety among adults in the United Kingdom: cohort study and nested feasibility trial. BMC Psychiatry 2024; 24:27. [PMID: 38184524 PMCID: PMC10771646 DOI: 10.1186/s12888-023-05446-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 12/06/2023] [Indexed: 01/08/2024] Open
Abstract
BACKGROUND People with severe COVID anxiety have poor mental health and impaired functioning, but the course of severe COVID anxiety is unknown and the quality of evidence on the acceptability and impact of psychological interventions is low. METHODS A quantitative cohort study with a nested feasibility trial. Potential participants aged 18 and over, living in the UK with severe COVID anxiety, were recruited online and from primary care services. We examined levels of COVID anxiety in the six months after recruitment, and factors that influenced this, using linear regression. Those scoring above 20 on the short Health Anxiety Inventory were invited to participate in a feasibility trial of remotely delivered Cognitive Behavioural Therapy for Health Anxiety (CBT-HA). Exclusion criteria were recent COVID-19, current self-isolation, or current receipt of psychological treatment. Key outcomes for the feasibility trial were the level of uptake of CBT-HA and the rate of follow-up. RESULTS 204 (70.2%) of 285 people who took part in the cohort study completed the six month follow-up, for whom levels of COVID anxiety fell from 12.4 at baseline to 6.8 at six months (difference = -5.5, 95% CI = -6.0 to -4.9). Reductions in COVID anxiety were lower among older people, those living with a vulnerable person, those with lower baseline COVID anxiety, and those with higher levels of generalised anxiety and health anxiety at baseline. 36 (90%) of 40 participants enrolled in the nested feasibility trial were followed up at six months. 17 (80.9%) of 21 people in the active arm of the trial received four or more sessions of CBT-HA. We found improved mental health and social functioning among those in the active, but not the control arm of the trial (Mean difference in total score on the Work and Social Adjustment Scale between baseline and follow up, was 9.7 (95% CI = 5.8-13.6) among those in the active, and 1.0 (95% C.I. = -4.6 to 6.6) among those in the control arm of the trial. CONCLUSIONS While the mental health of people with severe COVID anxiety appears to improve over time, many continue to experience high levels of anxiety and poor social functioning. Health anxiety is highly prevalent among people with severe COVID anxiety and may provide a target for psychological treatment. TRIAL REGISTRATION Retrospectively registered at ISRCTN14973494 on 09/09/2021.
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Affiliation(s)
- Mike J Crawford
- Division of Psychiatry, Commonwealth Building, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK.
| | - Jacob D King
- Division of Psychiatry, Commonwealth Building, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK
| | - Aisling McQuaid
- Division of Psychiatry, Commonwealth Building, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK
| | - Paul Bassett
- Statsconsultancy Ltd, Amersham, Buckinghamshire, UK
| | - Verity C Leeson
- Division of Psychiatry, Commonwealth Building, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK
| | - Oluwaseun Tella
- Division of Psychiatry, Commonwealth Building, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK
| | - Martina Di Simplicio
- Division of Psychiatry, Commonwealth Building, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK
| | - Peter Tyrer
- Division of Psychiatry, Commonwealth Building, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK
| | - Helen Tyrer
- Division of Psychiatry, Commonwealth Building, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK
| | - Richard G Watt
- Department of Epidemiology & Public Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Kirsten Barnicot
- Division of Health Services Research and Management, City, University of London, Northampton Square, London, EC1V 0HB, UK
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Zhang H, Yang Y, Hao X, Qin Y, Li K. Effects of digital sleep interventions on sleep and psychological health during the COVID-19 pandemic: A systematic review and meta-analysis. Sleep Med 2023; 110:190-200. [PMID: 37625326 DOI: 10.1016/j.sleep.2023.07.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 07/10/2023] [Accepted: 07/30/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Various digital sleep interventions have been implemented to address sleep and psychological complications during the coronavirus disease 2019 (COVID-19) pandemic. However, the characteristics and effectiveness of digital sleep interventions on sleep and psychological outcomes for people with sleep problems during the COVID-19 pandemic are unknown. METHODS The protocol of this systematic review and meta-analysis was registered on PROSPERO (ID: CRD42022325662), seven databases were searched from December 2019 to June 2023. Reference lists from digital sleep reviews were also identified and selected. Two reviewers independently screened eligible articles and extracted data. Quality appraisal was undertaken by two independent reviewers using the Cochrane Risk-of-Bias Tools. Data synthesis was conducted using fixed- or random-effects model based on the results of the heterogeneity test. RESULTS A total of 20 studies were identified, including nine randomised controlled trials (RCTs) and 11 non-RCTs, involving 3860 participants. Meta-analyses showed that digital sleep interventions significantly improve sleep quality, insomnia, and depression during the COVID-19 pandemic. Subgroup analysis showed that interventions of more than four weeks, healthcare workers as participants, and relaxation therapies may have the advantage of improving sleep quality. Most non-RCTs supported the efficacy of digital sleep interventions on sleep and psychological health. CONCLUSION Digital sleep interventions during the COVID-19 pandemic had significant effectiveness in improving sleep and psychological outcomes for people with sleep problems. More structured and personalised digital sleep interventions should be designed, and other diverse digital technologies could be used to improve sleep and psychological disorders.
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Affiliation(s)
- Huijing Zhang
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, 130012, China
| | - Yuhang Yang
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, 130012, China
| | - Xiaonan Hao
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, 130012, China
| | - Yuan Qin
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, 130012, China
| | - Kun Li
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, 130012, China.
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Yavuz C, Şahin S. The impact of a videoconferencing-ımplemented program on older adults' psychosocial health in the COVID-19 pandemic: an experimental study. Psychogeriatrics 2023. [PMID: 37072132 DOI: 10.1111/psyg.12961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/10/2023] [Accepted: 03/13/2023] [Indexed: 04/20/2023]
Abstract
BACKGROUND Social distancing and 'stay-at-home' orders are essential to contain the coronavirus outbreak; however, it has affected older adults very negatively psychosocially. The present study explored the impact of a videoconferencing-implemented program on older adults' psychosocial health during the COVID-19 pandemic. METHODS We carried out this experimental research with pretest-posttest and control groups between November 02 to December 26, 2020 on individuals aged 60 years and over who were enrolled at Fethiye Refreshment University (60+ FRU). While the intervention group consisted of 40 people, we recruited 52 participants in the control group. Unlike the control group, the intervention group participated in a structured videoconferencing program held there days a week for 8 weeks. We collected the data using the Fear of COVID-19 Scale (FCV-19S), the Multidimensional Scale of Perceived Social Support (MSPS), the Depression Anxiety Stress Scale (DASS-21), and the Loneliness Scale for Elderly (LSE). The data were then analysed on the SPSS 22.0 program. RESULTS The participants had a mean age of 66.13 ± 5.13 years; 65.2% were females, 58.7% were married, 55.4% held a university degree and 93.5% had a regular income. Following the intervention, we found the experimental group to have significantly a lower posttest FCV-19S score (p < 0.05) and a higher posttest MSPS score than the control group (p < 0.05). Besides, the experimental group had significantly lower posttest scores on the DASS-21 and the anxiety and stress subscales than the control group (p < 0.05). Moreover, the posttest score of the experiential group on the emotional loneliness subscale (LSE) was found to be significantly lower than that of the control group (p < 0.05); nevertheless, we could not conclude significant differences between the groups' pretest and posttest LSE scores and their scores on the other LSE subscales (p > 0.05). CONCLUSION Overall, the videoconferencing program was found to be efficient in providing older adults with psychosocial support amid social isolation.
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Affiliation(s)
- Cemil Yavuz
- Fethiye Faculty of Health Sciences, Department of Nursing, Mugla Sıtkı Kocman University, Mugla, Turkey
| | - Sevnaz Şahin
- Faculty of Medicine, Department of Internal Medicine/Geriatrics, Ege University, Izmir, Turkey
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