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Kuang R, Moldovan C, Drury S, Wagner H, Jellison F, Staack A. Effects of Mindfulness Meditation on Patient Experience During Urodynamics: A Prospective Study. Int Urogynecol J 2024:10.1007/s00192-024-05911-3. [PMID: 39276281 DOI: 10.1007/s00192-024-05911-3] [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: 05/13/2024] [Accepted: 08/04/2024] [Indexed: 09/16/2024]
Abstract
INTRODUCTION AND HYPOTHESIS Urodynamics (UDS) assesses voiding dysfunction using intravesical, vaginal, or rectal catheters, which can be distressing. This study was aimed at utilizing mindfulness to reduce anxiety and pain in patients undergoing UDS. METHODS A single-institution randomized controlled trial was conducted on 60 patients who underwent UDS. Patients were assigned to a mindfulness group (n = 30) or a control group (n = 30). Before UDS testing, all patients completed validated questionnaires assessing lower urinary tract symptoms (Urogenital Distress Inventory 6, UDI-6), anxiety (State-Trait Anxiety Inventory 6, STAI-6), and pain (Visual Analog Scale, VAS). The mindfulness group listened to a mindfulness audio prompt before UDS. All patients received standardized UDS education before UDS testing in a calm environment. After UDS testing, all patients completed validated UDS-perception questionnaires, STAI-6, Likert scale, and VAS surveys. Statistical analysis was performed using paired t tests, independent t tests, Wilcoxon, and Chi-squared tests. RESULTS Both groups had similar demographics, history of prior UDS, anxiety, and baseline UDI-6 and STAI-6. Post-UDS, anxiety scores decreased in both groups, with the mindfulness group reporting significant improvement in "calmness" (mean 1.7, SD = 0.84) compared with the control group (mean 2.3, SD = 1.0, p < 0.05). The mindfulness group reported increased relaxation whereas the control group reported decreased relaxation post-UDS. Patients in both groups without a history of UDS had a significant improvement in total anxiety compared with those with a history of UDS. CONCLUSION Mindfulness meditation may improve calmness and relaxation for patients undergoing UDS.
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Affiliation(s)
- Ruby Kuang
- Department of Urology, Loma Linda University, Loma Linda, CA, USA
| | | | - Sydney Drury
- Department of Urology, Loma Linda University, Loma Linda, CA, USA
| | - Hillary Wagner
- Department of Urology, Loma Linda University, Loma Linda, CA, USA
| | - Forrest Jellison
- Department of Urology, Loma Linda University, Loma Linda, CA, USA
| | - Andrea Staack
- Department of Urology, Loma Linda University, Loma Linda, CA, USA.
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Trapani S, Villa G, Poliani A, Gnecchi S, Rosa D, Manara DF. Non-Pharmacological Management of Urge Urinary Incontinence in Women between 40 and 65 Years Old: A Systematic Review. NURSING REPORTS 2024; 14:174-196. [PMID: 38251193 PMCID: PMC10801617 DOI: 10.3390/nursrep14010015] [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: 10/25/2023] [Revised: 01/03/2024] [Accepted: 01/06/2024] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Urinary incontinence (UI) has been identified as a World Health Organization health priority. In particular, urge UI (UUI) refers to urine leakage associated with a sudden and compelling desire to void urine. It affects quality of life more than other kinds of UI, but it is not always treated adequately. For these reasons, this study aimed to evaluate the effectiveness of conservative treatment practices to counteract UUI in women aged 40-65 years old. METHODS This systematic review was conducted following the Joanna Briggs Institute (JBI) methodology. According to the protocol registered in PROSPERO, a systematic search was carried out in the CINAHL, Embase, PubMed, PsycInfo, Scopus and Web of Science databases up to October 2022, to find primary studies meeting the inclusion criteria. RESULTS Fourteen studies were included. The scientific literature reported different strategies dealing with the problem of UUI, some purely physical, others physical and psycho-educational and others exclusively psychological. CONCLUSION Conservative treatments are useful to aid the reduction in UUI episodes in middle-aged women. However, none of them can be considered more effective than others due to the impossibility of conducting meta-analytical analyses. Further studies comparing the effectiveness of conservative treatments for UUI are needed.
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Affiliation(s)
- Sara Trapani
- Department of Obstetrics and Gynecology, IRCCS San Raffaele Hospital, 20132 Milan, Italy;
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Giulia Villa
- Center for Nursing Research and Innovation, Vita-Salute San Raffaele University, 20132 Milan, Italy; (A.P.); (D.R.); (D.F.M.)
| | - Andrea Poliani
- Center for Nursing Research and Innovation, Vita-Salute San Raffaele University, 20132 Milan, Italy; (A.P.); (D.R.); (D.F.M.)
| | - Silvia Gnecchi
- Department of Onco-Hematology, IRCCS San Raffaele Hospital, 20132 Milan, Italy;
| | - Debora Rosa
- Center for Nursing Research and Innovation, Vita-Salute San Raffaele University, 20132 Milan, Italy; (A.P.); (D.R.); (D.F.M.)
| | - Duilio F. Manara
- Center for Nursing Research and Innovation, Vita-Salute San Raffaele University, 20132 Milan, Italy; (A.P.); (D.R.); (D.F.M.)
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Chang YC. Effectiveness of Integrated Mindfulness-Based Fitness Training Program in Ameliorating Physical Symptoms and Survivor Concerns in Patients With Breast Cancer: A Randomized Clinical Trial. Cancer Nurs 2023:00002820-990000000-00175. [PMID: 38158601 DOI: 10.1097/ncc.0000000000001285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
BACKGROUND Patients with breast cancer typically experience both mental and physical distress after aggressive treatments. Some studies have explored the use of integrated interventions, such as mindfulness-based or exercise-based approaches, to reduce these symptoms. However, the results of these studies have been conflicting. OBJECTIVE The aim of this study was to evaluate the effectiveness of an integrated mindfulness-based fitness training (MBFT) program in addressing overactive bladder, fear of cancer recurrence, and female sexual function in patients with breast cancer. METHODS Fifty patients with breast cancer were either assigned to an 8-week MBFT group or a waitlist control group. The postintervention and preintervention scores were compared using descriptive analysis of the data set, as well as paired and independent t tests. RESULTS There was no significant improvement in overactive bladder symptoms. Significant differences were observed in survivor concerns for items related to future diagnostic tests (t = 2.667, P = .024; 95% confidence interval [CI], 0.120-1.335), another type of cancer (t = 2.667, P = .024; 95% CI, 0.120-1.335), cancer coming back (t = 4.183, P = .002; 95% CI, 0.297-0.975), dying (t = 2.609, P = .026; 95% CI, 0.093-1.180), and my health (t = 2.887, P = .016; 95% CI, 0.104-0.805). A significant difference was found in the item measuring overall sexual life satisfaction (t = -3.162, P = .013) and sexual desire (MBFT vs waitlist control group, 2.00 vs 1.18; P = .023). CONCLUSION Mindfulness-based fitness training interventions were effective in enhancing the well-being of patients with breast cancer by reducing fear of recurrence and enhancing sexual function. These findings support the use of MBFT as complementary therapy. IMPLICATIONS FOR PRACTICE Healthcare providers should carefully assess the individual needs and preferences of each patient and tailor interventions accordingly. In addition, integrating multiple approaches may be more effective in reducing distress.
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Affiliation(s)
- Yun-Chen Chang
- Author Affiliations: School of Nursing and Graduate Institute of Nursing, China Medical University; and Nursing Department, China Medical University Hospital, Taichung, Taiwan
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Evidence-Informed, Interdisciplinary, Multidimensional Action Plan to Advance Overactive Bladder Research and Treatment Initiatives: Directives From State-of-the-Science Conference on Overactive Bladder and Cognitive Impairment. UROGYNECOLOGY (HAGERSTOWN, MD.) 2023; 29:S20-S39. [PMID: 36548637 DOI: 10.1097/spv.0000000000001274] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
ABSTRACT This article outlines an evidence-informed, interdisciplinary, multidimensional, comprehensive action plan for the American Urogynecologic Society to improve care of women with overactive bladder (OAB) while minimizing treatment-related adverse events, including cognitive impairment. It is a "call to action" to advance basic, translational, and clinical research and summarizes initiatives developed at the State-of-the-Science Conference on OAB and Cognitive Impairment to (1) develop framework for a new OAB treatment approach in women, (2) define research gaps and future research priorities, (3) champion health equity and diversity considerations in OAB treatment, (4) foster community and promote education to remove stigma surrounding OAB and urinary incontinence, and (5) elevate visibility and impact of OAB, by creating partnerships through education and engagement with health care professionals, industry, private and public payers, funding agencies, and policymakers.
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Hardison ME, Unger J, Roll SC. Hand Therapy Patients' Psychosocial Symptomology and Interests in Mindfulness: A Cross-Sectional Study. The Canadian Journal of Occupational Therapy 2021; 89:44-50. [PMID: 34783575 DOI: 10.1177/00084174211060120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Psychosocial sequelae are common for individuals with physical injuries to the upper extremity. However, psychosocially oriented interventions are not common in this occupational therapy practice area. Purpose: This study implemented an online survey of hand therapy patients' psychological symptoms. Second, it explored patients' interest in one psychosocially oriented intervention: mindfulness meditation. Methods: The design was a cross-sectional survey of 120 consecutively recruited hand therapy patients. Survey measures included functioning, psychosocial factors, and trait mindfulness. Findings: Anxiety was prevalent in this sample, and moderately correlated with trait mindfulness (r = -0.542, p < .001). While most participants (77%) indicated mindfulness meditation would be an acceptable intervention, women were 2.8 times as likely to be interested (p = .044). Implications: Psychosocially oriented interventions are indicated in hand therapy based on the prevalence of these symptoms. Further examination of using mindfulness meditation in hand therapy is warranted due to patient interest.
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Affiliation(s)
- Mark E Hardison
- Occupational Therapy Graduate Program, 12289University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Jennifer Unger
- Preventive Medicine at the University of Southern California, Keck School of Medicine, Los Angeles, USA
| | - Shawn C Roll
- Division of Occupational Science and Occupational Therapy, 5116University of Southern California, Los Angeles, USA
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Şener N, Timur Taşhan S. The effects of mindfulness stress reduction program on postmenopausal women's menopausal complaints and their life quality. Complement Ther Clin Pract 2021; 45:101478. [PMID: 34543872 DOI: 10.1016/j.ctcp.2021.101478] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 08/16/2021] [Accepted: 08/28/2021] [Indexed: 11/30/2022]
Abstract
AIM This study was carried out to define the effect of the Mindfulness Stress Reduction Program (MBSR) applied among postmenopausal women on their menopausal complaints and quality of life. MATERIAL AND METHOD The study was conducted with a quasi-experimental design. The sample consisted of 118 women, including 55 in the experimental group and 63 in the control group. A Personal Information Form, the Mindful Attention Awareness Scale (MAAS), the Menopausal Symptoms Rating Scale (MRS) and the Menopause Specific Quality of Life Questionnaire (MENQOL) were used to obtain the participants' data. An 8-week Mindfulness Stress Reduction Program was applied among the women in the experimental group. After the pretest, both groups completed the midtest at eight weeks and the posttests covering MAAS, MRS and MENQOL at 16 weeks. The data were analyzed by using descriptive statistics, independent-samples t-test, chi-squared test, ANOVA and Cronbach's alpha analysis. FINDINGS It was observed that, in the midtest and posttest, there was a significant difference between the MRS total and psychological complaints domain scores of the women in the experimental and control groups (p < 0.05). In the midtest, there was a significant difference in the vasomotor, psychosocial, sexual domains and scale total scores between the experimental and control groups (p < 0.05). In the posttest of the women in the experimental and control groups, a significant difference was found between these groups in the MENQOL vasomotor area, psychosocial area, physical area domains and scale total scores (p < 0.05). RESULT The MBSR program reduced the menopausal symptoms and increased the quality of life of the postmenopausal women.
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Affiliation(s)
- Nurdilan Şener
- Fırat University, Faculty of Health Sciences, Department of Nursing, Elazığ, Turkey.
| | - Sermin Timur Taşhan
- Inonu University, Faculty of Health Sciences, Department of Nursing, Malatya, Turkey.
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Chess-Williams R, McDermott C, Sellers DJ, West EG, Mills KA. Chronic psychological stress and lower urinary tract symptoms. Low Urin Tract Symptoms 2021; 13:414-424. [PMID: 34132480 DOI: 10.1111/luts.12395] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/20/2021] [Accepted: 05/24/2021] [Indexed: 12/30/2022]
Abstract
It is well established that lower urinary tract symptoms (LUTS), particularly urinary urgency and incontinence, cause stress and anxiety for patients. However, there is mounting evidence that the relationship between these two factors is bidirectional and that chronic psychological stress itself can result in the development of symptoms such as urinary frequency, urgency, incontinence, and pelvic pain. This review considers the evidence that such a relationship exists and reviews the literature from clinical and animal studies to identify some of the mechanisms that might be involved. Inflammatory responses induced by chronic stress appear to offer the strongest link to bladder dysfunction. There is overwhelming evidence, both in patients and animal models, for a release of pro-inflammatory cytokines and chemokines during periods of chronic stress. Furthermore, cytokines have been shown to cause bladder dysfunction and pain via actions in the central nervous system and locally in the bladder. In the brain and spinal cord, pro-inflammatory cytokines influence the regulation of micturition pathways by corticotropin-releasing factor (CRF) and its receptors, while peripherally cytokines affect bladder function, directly causing detrusor hypertrophy and afferent nerve hypersensitivity. There is little information on which treatments may have most benefit for stressed/anxious patients with LUTS, but animal studies suggest traditional drugs for overactive bladder (solifenacin, mirabegron) are more effective on LUTS than anxiolytic drugs (fluoxetine, imipramine). The preliminary preclinical data for CRF receptor antagonists is not consistent. A clearer understanding of the mechanisms involved in stress-induced LUTS should provide a basis for improved treatment of this condition.
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Affiliation(s)
- Russ Chess-Williams
- Centre for Urology Research, Faculty of Health Sciences & Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Catherine McDermott
- Centre for Urology Research, Faculty of Health Sciences & Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Donna J Sellers
- Centre for Urology Research, Faculty of Health Sciences & Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Eliza G West
- Centre for Urology Research, Faculty of Health Sciences & Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Kylie A Mills
- Centre for Urology Research, Faculty of Health Sciences & Medicine, Bond University, Gold Coast, Queensland, Australia
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Taple BJ, Griffith JW, Weaver C, Kenton KS. Enhancing behavioral treatment for women with pelvic floor disorders: Study protocol for a pilot randomized controlled trial. Contemp Clin Trials Commun 2020; 17:100514. [PMID: 31956723 PMCID: PMC6962649 DOI: 10.1016/j.conctc.2019.100514] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 12/12/2019] [Accepted: 12/30/2019] [Indexed: 12/19/2022] Open
Abstract
Approximately one in four American women report bothersome urinary symptoms (e.g., urgency, frequency), which greatly impact quality of life, including mental health. Bidirectional relationships have been found between urinary symptoms and anxiety, such that urinary symptoms worsen emotional distress (i.e., anxiety and depression), and in turn anxiety can exacerbate these symptoms. Current methods to treat urinary symptoms, such as physical therapy and medications, do not address their emotional impact. As such, our multidisciplinary team is conducting a randomized control trial (RCT) of cognitive-behavior therapy (CBT) using the Unified Protocol (UP) versus supportive therapy in the context of integrated behavioral treatment in the urogynecology context. Women with bothersome urinary symptoms and anxiety are recruited from the Northwestern Medicine Integrated Pelvic Health Program (IPHP) -a transdisciplinary clinic including urogynecologists, urologists, colorectal surgeons, nurses, and physical therapists- and Northwestern Medicine Urology. Participants are randomized to one of two interventions: UP or supportive therapy. All participants attend therapy once per week for 12 weeks. Assessments of urinary symptoms, anxiety, and other indicators of psychological and physical functioning are completed at baseline, mid-treatment, post-treatment, and at 3- and 6-month follow-ups using patient-reported outcomes. The study has been preregistered on clinicaltrails.gov (ID: NCT03623880) and is currently ongoing.
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Affiliation(s)
- Bayley J Taple
- Northwestern University Feinberg School of Medicine, Department of Medical Social Sciences, 625 N. Michigan Ave., 27th Floor, Chicago, IL, 60611, USA
| | - James W Griffith
- Northwestern University Feinberg School of Medicine, Department of Medical Social Sciences, 625 N. Michigan Ave., 27th Floor, Chicago, IL, 60611, USA
| | - Claire Weaver
- Northwestern University Feinberg School of Medicine, Department of Medical Social Sciences, 625 N. Michigan Ave., 27th Floor, Chicago, IL, 60611, USA
| | - Kimberly S Kenton
- Northwestern University Feinberg School of Medicine, Department of Obstetrics and Gynecology, Arkes Pavilion, 676 N. St. Clair St., Suite 950, Chicago, IL, 60611, USA
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Felsted KF, Supiano KP. Mindfulness-Based Stress Reduction Versus a Health Enhancement Program in the Treatment of Urge Urinary Incontinence in Older Adult Women: A Randomized Controlled Feasibility Study. Res Gerontol Nurs 2019; 12:285-297. [PMID: 31283830 DOI: 10.3928/19404921-20190702-02] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Accepted: 05/14/2019] [Indexed: 11/20/2022]
Abstract
Current treatment practices for older adult women with urge urinary incontinence (UUI) remain insufficient and ineffective. A randomized controlled feasibility trial was developed to evaluate three determinants of research feasibility and three determinants of intervention feasibility when comparing mindfulness-based stress reduction (MBSR) with a health enhancement program (HEP) in older adult women with UUI. Participants were recruited from the university health system, county senior centers, and community sites. Twenty-five postmenopausal women (mean age = 74 years) were randomized into MBSR treatment conditions or HEP comparison conditions for an 8-week intervention. Participants remained blinded to conditions. Research feasibility determinants were measured as recruitment, retention, and treatment delivery; intervention feasibility determinants were measured as acceptability, tolerability, and client receipt/enactment. Feasibility determinants established in the research literature as essential to intervention evaluation were recorded and evaluated throughout the current study. All six feasibility determinants confirmed positive results in the enrolled population. The use of MBSR and HEP as the active comparison to treat UUI in older adult women proved feasible in this trial. The results warrant the design of a larger-scale, multisite trial to study the efficacy of MBSR in treating UUI in older adult women. TARGETS Older adult women with high incidence of UUI. INTERVENTION DESCRIPTION MBSR treatment conditions or HEP comparison conditions. MECHANISMS OF ACTION Research and intervention feasibility determinants. OUTCOMES The use of MBSR and HEP as the active comparison to treat UUI in older adult women proved feasible in this trial. [ Research in Gerontological Nursing, 12(6), 285-297.].
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Cunningham R, Valasek S. Occupational Therapy Interventions for Urinary Dysfunction in Primary Care: A Case Series. Am J Occup Ther 2019; 73:7305185040p1-7305185040p8. [PMID: 31484023 DOI: 10.5014/ajot.2019.038356] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Urinary dysfunction is commonly reported in primary care contexts. A shortage of primary care providers is affecting access to relevant services. Occupational therapy practitioners work in primary care settings and typically address urinary dysfunction in an outpatient context. Evidence regarding the delivery of occupational therapy interventions for urinary dysfunction in primary care has been limited. In this study, 3 women received 9-14 occupational therapy sessions in a primary care setting to address urinary symptoms. Plan-of-care duration, assessments, and urinary dysfunction interventions were individualized to accommodate personal and environmental factors. Across all case-series participants, Canadian Occupational Performance Measure scores demonstrated clinically significant improvement. Mixed results were found for SF-36 health-related quality-of-life subscale scores. Assessment scores specific to urinary dysfunction decreased, indicating reduced symptom severity and functional impact. This article provides preliminary evidence regarding the feasibility of occupational therapy interventions addressing urinary dysfunction in primary care settings.
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Affiliation(s)
- Rebecca Cunningham
- Rebecca Cunningham, OTD, OTR/L, is Assistant Professor of Clinical Occupational Therapy, Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles;
| | - Samantha Valasek
- Samantha Valasek, OTD, OTR/L, is Assistant Professor of Clinical Occupational Therapy, Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles
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Long JE, Khairat S, Chmelo E, Palmer MH. Mind over bladder: Women, aging, and bladder health. Geriatr Nurs 2017; 39:230-237. [PMID: 29042069 DOI: 10.1016/j.gerinurse.2017.09.003] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 09/05/2017] [Accepted: 09/08/2017] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to explore the efficacy and acceptability of an innovative, electronically delivered self-management intervention for urinary incontinence (UI) that included daily mindfulness practice, completion of sequential bladder diaries, and bladder health education to improve UI in older women living independently in a retirement community. A mixed methods pilot study was conducted over ten weeks using a custom website or CD. Ten women were recruited and 8 completed the study; 5 of those (71%) experienced fewer daily UI episodes post intervention (p = 0.055). The women also reported a statistically significant decrease in the impact UI had on their everyday life (p = 0.04). Seventy-one percent (N = 5) reported subjective improvement in UI, and high acceptability scores also were achieved. The intervention was both effective in helping older women self-manage UI and acceptable to the population group. Further research is needed with a larger and diverse population of older women.
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Affiliation(s)
- Joanna E Long
- University of North Carolina at Chapel Hill, School of Nursing, Carrington Hall, S. Columbia Street, Chapel Hill, NC, 27599, USA.
| | - Saif Khairat
- Salemtowne Retirement Community, 1000 Salemtowne Drive, Winston-Salem, NC, 27106, USA.
| | - Elizabeth Chmelo
- University of North Carolina at Chapel Hill, School of Nursing, Carrington Hall, S. Columbia Street, Chapel Hill, NC, 27599, USA.
| | - Mary H Palmer
- University of North Carolina at Chapel Hill, School of Nursing, Carrington Hall, S. Columbia Street, Chapel Hill, NC, 27599, USA.
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Hardison ME, Roll SC. Mindfulness Interventions in Physical Rehabilitation: A Scoping Review. Am J Occup Ther 2016; 70:7003290030p1-9. [PMID: 27089297 PMCID: PMC4834757 DOI: 10.5014/ajot.2016.018069] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
A scoping review was conducted to describe how mindfulness is used in physical rehabilitation, identify implications for occupational therapy practice, and guide future research on clinical mindfulness interventions. A systematic search of four literature databases produced 1,524 original abstracts, of which 16 articles were included. Although only 3 Level I or II studies were identified, the literature included suggests that mindfulness interventions are helpful for patients with musculoskeletal and chronic pain disorders and demonstrate trends toward outcome improvements for patients with neurocognitive and neuromotor disorders. Only 2 studies included an occupational therapist as the primary mindfulness provider, but all mindfulness interventions in the selected studies fit within the occupational therapy scope of practice according to the American Occupational Therapy Association's Occupational Therapy Practice Framework: Domain and Process. Higher-level research is needed to evaluate the effects of mindfulness interventions in physical rehabilitation and to determine best practices for the use of mindfulness by occupational therapy practitioners.
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Affiliation(s)
- Mark E Hardison
- Mark E. Hardison, MS, OTR/L, is PhD Student, Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles
| | - Shawn C Roll
- Shawn C. Roll, PhD, OTR/L, RMSKS, FAOTA, is Assistant Professor, Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles;
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Nardos R, Karstens L, Carpenter S, Aykes K, Krisky C, Stevens C, Gregory W, Fair DA. Abnormal functional connectivity in women with urgency urinary incontinence: Can we predict disease presence and severity in individual women using Rs-fcMRI/. Neurourol Urodyn 2015; 35:564-73. [DOI: 10.1002/nau.22767] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 02/25/2015] [Indexed: 01/23/2023]
Affiliation(s)
- Rahel Nardos
- Division of Female Pelvic Medicine and Reconstructive Surgery; Oregon Health & Science University; Portland Oregon
| | - Lisa Karstens
- Division of Female Pelvic Medicine and Reconstructive Surgery; Oregon Health & Science University; Portland Oregon
| | - Samuel Carpenter
- Department of Behavioral Neuroscience; Oregon Health & Science University; Portland Oregon
| | - Kamari Aykes
- Department of Behavioral Neuroscience; Oregon Health & Science University; Portland Oregon
| | - Christine Krisky
- Division of Female Pelvic Medicine and Reconstructive Surgery; Oregon Health & Science University; Portland Oregon
| | - Corrine Stevens
- Department of Behavioral Neuroscience; Oregon Health & Science University; Portland Oregon
| | - W.Thomas Gregory
- Division of Female Pelvic Medicine and Reconstructive Surgery; Oregon Health & Science University; Portland Oregon
| | - Damien A. Fair
- Department of Behavioral Neuroscience; Oregon Health & Science University; Portland Oregon
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Lai H, Gardner V, Vetter J, Andriole GL. Correlation between psychological stress levels and the severity of overactive bladder symptoms. BMC Urol 2015; 15:14. [PMID: 25887525 PMCID: PMC4357155 DOI: 10.1186/s12894-015-0009-6] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Accepted: 02/19/2015] [Indexed: 12/30/2022] Open
Abstract
Background The relationship between psychological stress and interstitial cystitis/bladder pain syndrome (IC/BPS) has been well described. Even though there is some overlapping of symptoms between overactive bladder (OAB) and IC/BPS, there have been very few studies that specifically investigated the relationship between psychological stress and urinary symptoms in OAB patients who do not have pelvic pain. Here we examined the relationship between psychological stress levels and the severity of overactive bladder (OAB) symptoms. Methods Patients diagnosed with OAB (n=51), IC/BPS (n=27), and age-matched healthy controls (n=30) participated in a case control study that inquired about their psychological stress levels using the perceived stress scale (PSS). PSS reported by the three patient groups were compared. Among OAB patients, their responses on the PSS was correlated to OAB symptoms using the following questionnaires: 1) international consultation on incontinence – urinary incontinence (ICIQ-UI), 2) international consultation on incontinence – overactive bladder (ICIQ-OAB), 3) OAB-q short form, 4) urogenital distress inventory (UDI-6), 5) incontinence impact questionnaire (IIQ-7), 6) urgency severity scale (USS), 7) numeric rating scales of urgency symptom, and 8) frequency symptom. Spearman’s correlation tests were performed to examine the relationship between psychological stress levels and the severity of OAB symptoms. Results OAB patients reported psychological stress levels that were as high as IC/BPS patients (median 17.0 versus 18.0, p=0.818, Wilcoxon sum rank test), and significantly higher than healthy controls (17.0, versus 7.5, p=0.001). Among OAB patients, there was a positive correlation between perceived stress levels and urinary incontinence symptoms (ICIQ-UI, Spearman’s correlation coefficient=0.39, p=0.007), and impacts on quality of life (UDI-6, IIQ-7, OAB-q quality of life subscale; Spearman’s correlation coefficient=0.32, 0.31, 0.39, and p=0.028, 0.005, 0.029, respectively). No significant correlation was observed between perceived stress levels and urgency or frequency symptoms (ICIQ-OAB, USS, numeric ratings of urgency and frequency). Conclusions OAB patients reported psychological stress levels that were as high as IC/BPS patients, and significantly higher than healthy controls. There was a positive correlation between perceived stress levels and urinary incontinence symptoms, and its impacts on quality of life among OAB patients.
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Affiliation(s)
- Henry Lai
- Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, 4960 Children's Place, Campus Box 8242, St Louis, MO, 63110, USA. .,Department of Anesthesiology, Washington University School of Medicine, 4960 Children's Place, Campus Box 8242, St Louis, MO, 63110, USA.
| | - Vivien Gardner
- Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, 4960 Children's Place, Campus Box 8242, St Louis, MO, 63110, USA.
| | - Joel Vetter
- Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, 4960 Children's Place, Campus Box 8242, St Louis, MO, 63110, USA.
| | - Gerald L Andriole
- Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, 4960 Children's Place, Campus Box 8242, St Louis, MO, 63110, USA.
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Comparison of mindfulness-based stress reduction versus yoga on urinary urge incontinence: a randomized pilot study. with 6-month and 1-year follow-up visits. Female Pelvic Med Reconstr Surg 2015; 20:141-6. [PMID: 24763155 DOI: 10.1097/spv.0000000000000061] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVES The objective of this study is to compare the effects of mindfulness-based stress reduction (MBSR) versus yoga on urinary urge incontinence (UI) at 8 weeks, 6 months, and 1 year after beginning an 8-week program. MATERIALS AND METHODS Participants in this prospective randomized single-masked pilot study were women aged 18 years or older with urge-predominant incontinence, 5 or more UI episodes (UIEs) on a 3-day voiding diary, and no recent anticholinergic use. Women were randomized to MBSR or yoga. The primary outcome was the percent change of UIE. RESULTS Of 30 enrollees (15 in MBSR, 15 in yoga), 24 completed at least 5 of 8 sessions (13 in MBSR and 11 in yoga). Twenty and 21 women completed the 6-month and 12-month follow-up visits, respectively. At 8 weeks, 6 months, and 12 months, the median percent change from the baseline in UIE on the intention-to-treat analysis was greater for the MBSR group (-55.6, -71.4, and -66.7, respectively) compared with that for the yoga group (-33.3, -11.8, and -16.7, respectively), with P values ranging from 0.01 to 0.08. On intention-to-treat analysis, the median percent change in the Overactive Bladder Symptom and Quality of Life-Short Form and the Health-Related Quality of Life was greater at each time point for MBSR than for yoga but was statistically significant only at 8 weeks (P = 0.003 and 0.02, respectively). As per protocol analysis, at 8 weeks, 6/13 and 0/11 women in MBSR and yoga, respectively, reported they were very much or much better (P = 0.02), whereas at 1 year, 6/12 and 1/9 women in MBSR and yoga, respectively, did so (P = 0.16). DISCUSSION These results support larger scale trials to evaluate MBSR, which seems to be a promising treatment of UI.
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Tenfelde S, Janusek LW. Yoga: A Biobehavioral Approach to Reduce Symptom Distress in Women with Urge Urinary Incontinence. J Altern Complement Med 2014; 20:737-42. [DOI: 10.1089/acm.2013.0308] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Sandi Tenfelde
- Department of Health Promotion, Loyola University Chicago, Marcella Niehoff School of Nursing, Chicago, IL
| | - Linda Witek Janusek
- Department of Health Promotion, Loyola University Chicago, Marcella Niehoff School of Nursing, Chicago, IL
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Amarenco G. Urinary disorders, behavioral and cognitive therapy and functional disorder. Ann Phys Rehabil Med 2014; 57:483-5. [PMID: 24954497 DOI: 10.1016/j.rehab.2014.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Revised: 05/19/2014] [Accepted: 05/19/2014] [Indexed: 11/25/2022]
Affiliation(s)
- G Amarenco
- Sorbonne universités, UPMC université Paris 06, GRC 01, GREEN, Group of Clinical Research in Neuro-Urology, 75005 Paris, France; AP-HP, hôpital Tenon, service de neuro-urologie, 75020 Paris, France.
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Penniston KL. Editorial Comment. Urology 2013; 82:1252-3. [DOI: 10.1016/j.urology.2013.06.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Carlson LE. Mindfulness-based interventions for physical conditions: a narrative review evaluating levels of evidence. ISRN PSYCHIATRY 2012; 2012:651583. [PMID: 23762768 PMCID: PMC3671698 DOI: 10.5402/2012/651583] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/26/2012] [Accepted: 09/19/2012] [Indexed: 12/13/2022]
Abstract
Research on mindfulness-based interventions (MBIs) for treating symptoms of a wide range of medical conditions has proliferated in recent decades. Mindfulness is the cultivation of nonjudgmental awareness in the present moment. It is both a practice and a way of being in the world. Mindfulness is purposefully cultivated in a range of structured interventions, the most popular of which is mindfulness-based stress reduction (MBSR), followed by mindfulness-based cognitive therapy (MBCT). This paper begins with a discussion of the phenomenological experience of coping with a chronic and potentially life-threatening illness, followed by a theoretical discussion of the application of mindfulness in these situations. The literature evaluating MBIs within medical conditions is then comprehensively reviewed, applying a levels of evidence rating framework within each major condition. The bulk of the research looked at diagnoses of cancer, pain conditions (chronic pain, low back pain, fibromyalgia, and rheumatoid arthritis), cardiovascular disease, diabetes, human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), and irritable bowel syndrome. Most outcomes assessed are psychological in nature and show substantial benefit, although some physical and disease-related parameters have also been evaluated. The field would benefit from more adequately powered randomized controlled trials utilizing active comparison groups and assessing the moderating role of patient characteristics and program "dose" in determining outcomes.
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Affiliation(s)
- Linda E. Carlson
- Division of Psychosocial Oncology, Department of Oncology, Faculty of Medicine, University of Calgary, Calgary, AB, Canada T2N 4N2
- Department of Psychosocial Resources, Tom Baker Cancer Centre, Alberta Health Services Cancer Care, Calgary, AB, Canada T2S 3C1
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