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Lehmann H, Otte N, Kraus T, Esser A, Krabbe J. Evaluation and Comparison of Relaxation-Related Workplace Interventions Among Office Workers at an Insurance Institution: An Intervention Study. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2024; 61:469580241242793. [PMID: 38591360 PMCID: PMC11005502 DOI: 10.1177/00469580241242793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 03/08/2024] [Accepted: 03/11/2024] [Indexed: 04/10/2024]
Abstract
Relaxation-related workplace interventions can be counterstrategies for stress due to office work and should be evaluated for success after implementation. This study reports on the evaluation and comparison of 3 relaxation techniques introduced as an intervention for health promotion. A Germany-wide multicenter evaluation of a 3-month relaxation intervention (30 min, once a week) including autogenic training, progressive muscle relaxation (PMR) or Tai Chi was conducted at 14 locations as an intervention study. Anonymous questionnaires (n = 244) were used to collect self-reports of perceived stress after the courses. Status before the courses (pre) and after completion (post) were reported at the end of the intervention. All 3 relaxation techniques were able to improve the subjective perception of stress (SPS) score. Autogenic training was reported to improve all singular items with large effects, whereas only 2 items showed change for Tai Chi and none for PMR. Singular items were also influenced by the location of the courses. All 3 methods were able to improve stress-related outcomes in terms of stress perception and individual aspects of stress management. For this specific intervention autogenic training yielded the largest and wide-ranging effects. Tai Chi was also effective, but additional effect due to an associated increase in physical activity were not found. For a workplace intervention PMR could not be recommended based on this study. The literature on workplace interventions is surprisingly scarce, and future studies should focus on the selection of appropriate participants while avoiding potential bias.
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Affiliation(s)
- Heidi Lehmann
- RWTH Aachen University, Aachen, Germany
- Social Accident Insurance Institution for the Energy, Textile, Electrical and Media Products Sectors (BG ETEM), Köln, Germany
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Pawar A. Holistic soldier fitness: A concept for healthier tomorrow. Med J Armed Forces India 2023; 79:S376-S378. [PMID: 38144658 PMCID: PMC10746739 DOI: 10.1016/j.mjafi.2017.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- A.A. Pawar
- DGMS (Navy), IHQ, Ministry of Defence, Sena Bhavan, New Delhi, 110011, India
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Kluge MG, Maltby S, Kuhne C, Walker N, Bennett N, Aidman E, Nalivaiko E, Walker FR. Evaluation of a Virtual Reality Platform to Train Stress Management Skills for a Defense Workforce: Multisite, Mixed Methods Feasibility Study. J Med Internet Res 2023; 25:e46368. [PMID: 37930751 PMCID: PMC10659241 DOI: 10.2196/46368] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 08/24/2023] [Accepted: 09/18/2023] [Indexed: 11/07/2023] Open
Abstract
BACKGROUND Psychological stress-related injuries within first-responder organizations have created a need for the implementation of effective stress management training. Most stress management training solutions have limitations associated with scaled adoption within the workforce. For instance, those that are effective in civilian populations often do not align with the human performance culture embedded within first-responder organizations. Programs involving expert-led instructions that are high in quality are often expensive. OBJECTIVE This study sought to evaluate a tailored stress management training platform within the existing training schedule of the Australian Defense Force (ADF). The platform, known as Performance Edge (PE), is a novel virtual reality (VR) and biofeedback-enabled stress management skills training platform. Focusing on practical training of well-established skills and strategies, the platform was designed to take advantage of VR technology to generate an immersive and private training environment. This study aimed to assess the feasibility of delivering the VR platform within the existing group-based training context and intended training population. In this setting, the study further aimed to collect data on critical predictors of user acceptance and technology adoption in education, including perceived usability, usefulness, and engagement, while also assessing training impacts. METHODS This study used a mixed methods, multisite approach to collect observational, self-reported, and biometric data from both training staff and trainers within a real-world "on-base" training context in the ADF. Validated scales include the Presence Questionnaire and User Engagement Scale for perceived usefulness, usability, and engagement, as well as the State Mindfulness Scale and Relaxation Inventory, to gain insights into immediate training impacts for specific training modules. Additional surveys were specifically developed to assess implementation feedback, intention to use skills, and perceived training impact and value. RESULTS PE training was delivered to 189 ADF trainees over 372 training sessions. The platform was easy to use at an individual level and was feasible to deliver in a classroom setting. Trainee feedback consistently showed high levels of engagement and a sense of presence with the training content and environment. PE is overall perceived as an effective and useful training tool. Self-report and objective indices confirmed knowledge improvement, increased skill confidence, and increased competency after training. Specific training elements resulted in increased state mindfulness, increased physical relaxation, and reduced breathing rate. The ability to practice cognitive strategies in a diverse, private, and immersive training environment while in a group setting was highlighted as particularly valuable. CONCLUSIONS This study found the VR-based platform (PE) to be a feasible stress management training solution for group-based training delivery in a defense population. Furthermore, the intended end users, both trainers and trainees, perceive the platform to be usable, useful, engaging, and effective for training, suggesting end-user acceptance and potential for technology adoption.
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Affiliation(s)
- Murielle G Kluge
- Centre for Advanced Training Systems, Faculty of Health, Medicine & Wellbeing, The University of Newcastle, Callaghan, Australia
- School of Biomedical Sciences & Pharmacy, Faculty of Health, Medicine & Wellbeing, The University of Newcastle, Callaghan, Australia
| | - Steven Maltby
- Centre for Advanced Training Systems, Faculty of Health, Medicine & Wellbeing, The University of Newcastle, Callaghan, Australia
- School of Biomedical Sciences & Pharmacy, Faculty of Health, Medicine & Wellbeing, The University of Newcastle, Callaghan, Australia
| | - Caroline Kuhne
- Centre for Advanced Training Systems, Faculty of Health, Medicine & Wellbeing, The University of Newcastle, Callaghan, Australia
- School of Psychological Sciences, College of Engineering, Science and Environment, The University of Newcastle, Callaghan, Australia
| | - Nicole Walker
- Army School of Health, Australian Defence Force, Canberra, Australia
| | - Neanne Bennett
- Joint Health Command, Department of Defence, Canberra, Australia
| | - Eugene Aidman
- School of Biomedical Sciences & Pharmacy, Faculty of Health, Medicine & Wellbeing, The University of Newcastle, Callaghan, Australia
- Human and Decision Sciences Division, Defence Science & Technology Group, Edinburgh, Australia
| | - Eugene Nalivaiko
- Centre for Advanced Training Systems, Faculty of Health, Medicine & Wellbeing, The University of Newcastle, Callaghan, Australia
- School of Biomedical Sciences & Pharmacy, Faculty of Health, Medicine & Wellbeing, The University of Newcastle, Callaghan, Australia
| | - Frederick Rohan Walker
- Centre for Advanced Training Systems, Faculty of Health, Medicine & Wellbeing, The University of Newcastle, Callaghan, Australia
- School of Biomedical Sciences & Pharmacy, Faculty of Health, Medicine & Wellbeing, The University of Newcastle, Callaghan, Australia
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Li Y, Chen J, Chen B, Wang T, Wu Z, Huang X, Li S. Effect of mindfulness meditation on depression during pregnancy: A meta-analysis. Front Psychol 2022; 13:963133. [PMID: 36186359 PMCID: PMC9515986 DOI: 10.3389/fpsyg.2022.963133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/16/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose This study systematically evaluates the effect of mindfulness meditation on depression during pregnancy. We provide evidence-based suggestions for preventing and reducing depression during pregnancy by exploring the most effective intervention mode, cycle, and frequency of mindfulness meditation. Methods Records were retrieved from PubMed, Web of Science, EBSCO, and Science Direct. A total of 1,612 randomized controlled trial studies on the effect of mindfulness meditation on pregnancy depression were collected. 10 studies with 658 subjects meeting the inclusion criteria were extracted and analyzed by Revman 5.3 to evaluate study qualities. Stata 12.0 was used for the meta-analysis. Results Mindfulness meditation had a positive effect on depression during pregnancy [standardized difference of the mean (SMD) = -0.786, 95% confidence interval (-1.289, -0.283), P < 0.001]. Subgroup analysis showed that mindfulness-based cognitive therapy (MBCT) had the best intervention effect on depression during pregnancy (SMD = 2.795), the best intervention duration was below 4 weeks (SMD = 1.756), applied from the first to the third stage of pregnancy (SMD = 1.024), the frequency guided by experts was less than six times a week (SMD = 2.055) of <60 min each time (SMD = 1.068), and completing homework by themselves every day for 30 mins (SMD = 1.822) was most significant for the improvement of depression during pregnancy. We found high heterogeneity across studies [q = 97.003, DF = 10, I2 = 88.0% (P < 0.001), I2 > 75%]. This may be caused by variance in measurement tools, among which Beck Depression Inventory-II was a significant source of heterogeneity. Conclusion Mindfulness meditation can improve the prevention, remission, and reduction of depression during pregnancy and can be used as an auxiliary measure for the clinical treatment of pregnancy depression.
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Affiliation(s)
- Yuchao Li
- Sports Department, University of Electronic Science and Technology of China, Chengdu, China
| | - Jinghui Chen
- School of Physical Education, Sichuan University, Chengdu, China
| | - Baoxia Chen
- School of Physical Education, Sichuan University, Chengdu, China
| | - Tingting Wang
- Sports Department, Chengdu Normal Primary School Attached Huarun, Chengdu, China
| | - Zhusheng Wu
- School of Physical Education, Sichuan University, Chengdu, China
| | - Xia Huang
- School of Physical Education, Sichuan University, Chengdu, China
| | - Shanshan Li
- School of Physical Education, Sichuan University, Chengdu, China
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Jacobs E, Keegan RJ. Sustaining optimal performance when the stakes could not be higher: Emotional awareness and resilience in emergency service personnel (with learnings for elite sport). Front Psychol 2022; 13:891585. [PMID: 36118503 PMCID: PMC9472212 DOI: 10.3389/fpsyg.2022.891585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 08/08/2022] [Indexed: 11/13/2022] Open
Abstract
Emergency services personnel are a high stress occupation, being frequently confronted with highly consequential stressors and expected to perform: without fault; under high pressure; and in unpredictable circumstances. Research often invokes similarities between the experiences of emergency services personnel and elite athletes, opening up the possibility of transferring learnings between these contexts. Both roles involve genuine risks to emotional wellbeing because their occupations involve significant stress. Similarly, both roles face obstacles and injury, and their "success" is dependent on high-quality execution of their skills under pressure. As such, both occupations are required to have resilience and effective coping abilities to ensure psychological well-being. Researchers suggest emotional awareness may be a key variable in the management and maintenance of resilience. This study: (1) explored the experiences of emergency services personnel; (2) characterised connections between emotional awareness and resilience; and (3) reflected on the ways these findings can be extrapolated to elite athletes. We analysed 11 interviews with emergency services personnel. Participants identified resilience as crucial when coping with stress, however, many defined resilience as remaining unaffected by stress rather than, for example, managing and responding to it. Participants defined emotional awareness as understanding their emotions, and they recognised associated benefits for coping, resilience, and burnout. Nevertheless, most participants did not engage in practices to improve their emotional awareness. Barriers, such as maladaptive beliefs and help-seeking stigma, interfered with participants' ability to cultivate emotional awareness, to promote resilience. In contrast, some participants described profound improvements in resilience and coping following the cultivation of emotional awareness. This finding illustrates that systemic change must target the individual, team, and organisation to correct misperceptions about resilience, emotional awareness, and psychological help-seeking. Developing emotional awareness may help emergency services personnel and other high stress occupations like elite athletes process difficult experiences and enhance their resilience, promoting well-being, and career longevity.
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Affiliation(s)
- Emily Jacobs
- Faculty of Health, University of Canberra, Canberra, ACT, Australia
| | - Richard J. Keegan
- Faculty of Health, University of Canberra, Canberra, ACT, Australia
- Research Institute for Sport and Exercise, Faculty of Health, University of Canberra, Canberra, ACT, Australia
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Kluge MG, Maltby S, Walker N, Bennett N, Aidman E, Nalivaiko E, Walker FR. Development of a modular stress management platform (Performance Edge VR) and a pilot efficacy trial of a bio-feedback enhanced training module for controlled breathing. PLoS One 2021; 16:e0245068. [PMID: 33529187 PMCID: PMC7853514 DOI: 10.1371/journal.pone.0245068] [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: 09/22/2020] [Accepted: 12/21/2020] [Indexed: 11/18/2022] Open
Abstract
This paper describes the conceptual design of a virtual reality-based stress management training tool and evaluation of the initial prototype in a pilot efficacy study. Performance Edge virtual-reality (VR) was co-developed with the Australian Defence Force (ADF) to address the need for practical stress management training for ADF personnel. The VR application is biofeedback-enabled and contains key stress management techniques derived from acceptance and commitment and cognitive behavioural therapy in a modular framework. End-user-provided feedback on usability, design, and user experience was positive, and particularly complimentary of the respiratory biofeedback functionality. Training of controlled breathing delivered across 3 sessions increased participants' self-reported use of breath control in everyday life and progressively improved controlled breathing skills (objectively assessed as a reduction in breathing rate and variability). Thus the data show that a biofeedback-enabled controlled breathing protocol delivered through Performance Edge VR can produce both behaviour change and objective improvement in breathing metrics. These results confirm the validity of Performance Edge VR platform, and its Controlled Breathing module, as a novel approach to tailoring VR-based applications to train stress management skills in a workplace setting.
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Affiliation(s)
- Murielle G. Kluge
- Centre for Advanced Training Systems, Faculty of Health & Medicine, The University of Newcastle, Callaghan, NSW, Australia
- School of Biomedical Sciences & Pharmacy, Faculty of Health & Medicine, The University of Newcastle, Callaghan, NSW, Australia
| | - Steven Maltby
- Centre for Advanced Training Systems, Faculty of Health & Medicine, The University of Newcastle, Callaghan, NSW, Australia
- School of Biomedical Sciences & Pharmacy, Faculty of Health & Medicine, The University of Newcastle, Callaghan, NSW, Australia
| | - Nicole Walker
- Army School of Health, Latchford Barracks, Bonegilla, VIC, Australia
| | | | - Eugene Aidman
- School of Biomedical Sciences & Pharmacy, Faculty of Health & Medicine, The University of Newcastle, Callaghan, NSW, Australia
- Land Division, Defence Science & Technology Group, Edinburgh, SA, Australia
- School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Eugene Nalivaiko
- Centre for Advanced Training Systems, Faculty of Health & Medicine, The University of Newcastle, Callaghan, NSW, Australia
- School of Biomedical Sciences & Pharmacy, Faculty of Health & Medicine, The University of Newcastle, Callaghan, NSW, Australia
| | - Frederick Rohan Walker
- Centre for Advanced Training Systems, Faculty of Health & Medicine, The University of Newcastle, Callaghan, NSW, Australia
- School of Biomedical Sciences & Pharmacy, Faculty of Health & Medicine, The University of Newcastle, Callaghan, NSW, Australia
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Group hypnosis for stress reduction and improved stress coping: a multicenter randomized controlled trial. BMC Complement Med Ther 2020; 20:344. [PMID: 33187503 PMCID: PMC7664040 DOI: 10.1186/s12906-020-03129-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 10/22/2020] [Indexed: 11/16/2022] Open
Abstract
Background The aim of the trial was to investigate the effect of a hypnotherapeutic group program in healthy persons with increased levels of perceived stress. Methods In a randomized controlled multicenter trial participants with a self-assessed subjective stress level ≥ 40 mm on a visual analogue scale (0–100 mm; VAS) for the previous week and a stable state of health were randomized to either 5 weekly sessions of 120-min duration of a hypnotherapeutic group program for stress reduction and improved stress coping plus 5 hypnosis audiorecords for individual practice at home plus an educational booklet for stress coping (hypnosis group) versus an educational booklet only (control group). The primary outcome parameter was the VAS stress level for the previous week after 5 weeks. Secondary outcome parameters included the VAS stress level after 12 weeks, perceived stress (CPSS), depression (ADS-K), self efficacy (SWE) and quality of life (SF 36) after 5 weeks and 12 weeks. Analysis of covariance with a significance level of 5% using the full analysis set was used for analysis; the model included treatment (fixed effect), VAS baseline value (fixed covariate), and center (random effect). Results A total of 95 participants were randomized; 47 (40 female, 45 ± 13.4 years of age) were allocated to the hypnosis group, and 48 (41 female, 46.9 ± 14.3 years) were allocated to the control group. Regarding VAS stress level after 5 weeks, the adjusted VAS mean in the hypnosis group was 41.8 mm [95% confidence interval (CI): 35.2; 48.4] compared to 62.9 mm [56.2; 69.7] in the control group, and the group difference was − 21.2 mm [− 30.1; − 12.2] (P < 0.001). After 12 weeks, the stress intensity on the VAS showed a between-group difference of − 14.7 mm [− 25.1; − 4.4] (P = 0.006), and the adjusted means were 41.1 mm [33.4; 48.8] in the hypnosis group and 55.9 mm [48.4; 63.5] in the control group. Improvements were also reported for CPSS, SF-36, SWE and ADS-K after 5 and 12 weeks. Conclusion Compared to the control group, the hypnosis group showed reduced perceived stress after 5 and 12 weeks. Trial registration ClinicalTrials.gov NCT03525093; date of registration: May 15, 2018.
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Mantoudi A, Parpa E, Tsilika E, Batistaki C, Nikoloudi M, Kouloulias V, Kostopoulou S, Galanos A, Mystakidou K. Complementary Therapies for Patients with Cancer: Reflexology and Relaxation in Integrative Palliative Care. A Randomized Controlled Comparative Study. J Altern Complement Med 2020; 26:792-798. [PMID: 32924560 DOI: 10.1089/acm.2019.0402] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objectives: Comparison of the effects of reflexology and relaxation on pain, anxiety, and depression, and quality of life (QoL) of patients with cancer. Design: A stratified random sample was selected, using an experimental design. Location: An outpatient Palliative Care Unit in Attica, Greece. Subjects: 88 patients suffering with cancer. Interventions: The sample was randomly divided into two equal groups, a reflexology and a relaxation group. The number of interventions for both groups was six 30-min weekly sessions. Outcome measures: The Greek Brief Pain Inventory (G-BPI) was used to measure pain, the Greek Hospital Anxiety and Depression Scale for screening anxiety and depression, and finally the Short Form Health Survey was used to measure QoL. Measurements of the above tools were taken three times in both groups as follows: preintervention, at fourth and at sixth week of intervention. Results: Anxiety and depression for both groups exhibited a statistically significant decrease during the observation period (p < 0.001, η2 > 0.25) but at the sixth week, there was a more significant decrease in the reflexology group compared with the relaxation group (p = 0.062, η2 = 0.044 vs. p = 0.005, η2 = 0.096 for anxiety), (p = 0.006, η2 = 0.094 vs. p = 0.001, η2 = 0.138 for depression). QoL physical and mental component measurements were significantly greater for the reflexology group (p < 0.001, η2 = 0.168 and p = 0.017, η2 = 0.071, respectively). The baseline-to-sixth week G-BPI measurements were markedly decreased for the reflexology group (p = 0.207, η2 = 0.020). Conclusions: Both interventions, relaxation and reflexology, seemed to be effective in decreasing anxiety and depression in patients with cancer. However, reflexology was found to be more effective in improving QoL (physical component) and to have a greater effect on pain management than relaxation.
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Affiliation(s)
| | - Efi Parpa
- Pain Relief and Palliative Care Unit, Department of Radiology, Areteion Hospital, School of Medicine, National & Kapodistrian University of Athens, Athens, Greece
| | - Eleni Tsilika
- Pain Relief and Palliative Care Unit, Department of Radiology, Areteion Hospital, School of Medicine, National & Kapodistrian University of Athens, Athens, Greece
| | - Chrysanthi Batistaki
- Attikon University Hospital, School of Medicine, National & Kapodistrian University of Athens, Athens, Greece
| | - Maria Nikoloudi
- Pain Relief and Palliative Care Unit, Department of Radiology, Areteion Hospital, School of Medicine, National & Kapodistrian University of Athens, Athens, Greece
| | - Vassilios Kouloulias
- Radiotherapy Unit, Department of Radiology, Attikon University Hospital, School of Medicine, National & Kapodistrian University of Athens, Athens, Greece
| | - Sotiria Kostopoulou
- Pain Relief and Palliative Care Unit, Department of Radiology, Areteion Hospital, School of Medicine, National & Kapodistrian University of Athens, Athens, Greece
| | - Antonis Galanos
- Pain Relief and Palliative Care Unit, Department of Radiology, Areteion Hospital, School of Medicine, National & Kapodistrian University of Athens, Athens, Greece
| | - Kyriaki Mystakidou
- Pain Relief and Palliative Care Unit, Department of Radiology, Areteion Hospital, School of Medicine, National & Kapodistrian University of Athens, Athens, Greece
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Hilton LG, Marshall NJ, Motala A, Taylor SL, Miake-Lye IM, Baxi S, Shanman RM, Solloway MR, Beroesand JM, Hempel S. Mindfulness meditation for workplace wellness: An evidence map. Work 2019; 63:205-218. [PMID: 31156202 PMCID: PMC6598008 DOI: 10.3233/wor-192922] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 12/14/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Mindfulness interventions aim to foster greater attention and awareness of present moment experiences. Uptake of mindfulness programs in the workplace has grown as organizations look to support employee health, wellbeing, and performance. OBJECTIVE In support of evidence-based decision making in workplace contexts, we created an evidence map summarizing physical and mental health, cognitive, affective, and interpersonal outcomes from systematic reviews of randomized controlled trials (RCTs) of mindfulness interventions. METHODS We searched nine electronic databases to July 2017, dually-screened all reviews, and consulted topic experts to identify systematic reviews on mindfulness interventions. The distribution of evidence is presented as an evidence map in a bubble plot. RESULTS In total, 175 systematic reviews met inclusion criteria. Reviews included a variety of mindfulness-based interventions. The largest review included 109 randomized controlled trials. The majority of these addressed general health, psychological conditions, chronic illness, pain, and substance use. Twenty-six systematic reviews assessed studies conducted in workplace settings and with healthcare professionals, educators, and caregivers. The evidence map shows the prevalence of research by the primary area of focus. An outline of promising applications of mindfulness interventions is included. CONCLUSIONS The evidence map provides an overview of existing mindfulness research. It shows the body of available evidence to inform policy and organizational decision-making supporting employee wellbeing in work contexts.
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Affiliation(s)
- Lara G. Hilton
- Evidence-Based Practice Center (EPC), RAND Corporation, Santa Monica, CA, USA
- Deloitte Consulting LLP, Los Angeles, CA, USA
| | - Nell J. Marshall
- Evidence-Based Synthesis Program (ESP) Center, West Los Angeles VA Medical Center, Los Angeles, CA, USA
- VA Palo Alto Healthcare System, Palo Alto, CA, USA
| | - Aneesa Motala
- Evidence-Based Practice Center (EPC), RAND Corporation, Santa Monica, CA, USA
| | - Stephanie L. Taylor
- VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Department of Health Policy, UCLA, Los Angeles, CA, USA
| | - Isomi M. Miake-Lye
- Evidence-Based Synthesis Program (ESP) Center, West Los Angeles VA Medical Center, Los Angeles, CA, USA
| | - Sangita Baxi
- Evidence-Based Practice Center (EPC), RAND Corporation, Santa Monica, CA, USA
| | - Roberta M. Shanman
- Evidence-Based Practice Center (EPC), RAND Corporation, Santa Monica, CA, USA
| | - Michele R. Solloway
- Child and Adolescent Health Measurement Initiative, Department of Population, Family and Reproductive Health, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Jessica M. Beroesand
- Evidence-Based Synthesis Program (ESP) Center, West Los Angeles VA Medical Center, Los Angeles, CA, USA
| | - Susanne Hempel
- Evidence-Based Practice Center (EPC), RAND Corporation, Santa Monica, CA, USA
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Stoerkel E, Bellanti D, Paat C, Peacock K, Aden J, Setlik R, Walter J, Inman A. Effectiveness of a Self-Care Toolkit for Surgical Breast Cancer Patients in a Military Treatment Facility. J Altern Complement Med 2018; 24:916-925. [PMID: 30247967 PMCID: PMC6157373 DOI: 10.1089/acm.2018.0069] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Objective: To assess whether a self-care toolkit (SCT) provided to breast cancer patients undergoing surgery could mitigate distress and lessen symptoms associated with surgery. Design: One hundred women with breast cancer, planning to undergo initial surgery, were randomly assigned to either one of two groups: treatment as usual (TAU; n = 49) or TAU with the addition of an SCT (n = 51). The SCT contained an MP3 player with audio-files of guided mind–body techniques (breathing, progressive muscle relaxation, meditation, guided imagery, and self-hypnosis) and acupressure antinausea wristbands. Anxiety, pain, nausea, sleep, fatigue, global health, and quality of life (QOL) were assessed using validated outcome measures. Two inflammatory blood markers (erythrocyte sedimentation rate [ESR] and C-reactive protein [CRP]) were measured serially. Data were collected at baseline (T1), immediately before surgery (T2), within 10 h postoperatively (T3), and ∼2 weeks postsurgery (T4). Settings: Numerous studies have shown that psychological distress associated with a cancer diagnosis can affect pain perception and QOL. Results: Between T1 and T4, there were significant between-group differences in Patient-Reported Outcomes Measurement Information System (PROMIS)-57 scores of Pain Interference, Fatigue, and Satisfaction with Social Roles, favoring the SCT group compared with TAU (p = 0.005, p = 0.023, and p = 0.021, respectively). There was a significant mean change in Defense and Veterans Pain Rating Scale (DVPRS) scores from T2 to T3, with the SCT group having significantly smaller increases in postoperative pain (p = 0.008) and in postoperative ESR (p = 0.0197) compared with the TAU group. Clinically significant reductions in anxiety occurred in the SCT group during the main intervention period. Conclusion: These results suggest that using the SCT in the perioperative period decreased pain perceptions, fatigue, and inflammatory cytokine secretion.
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Affiliation(s)
- Erika Stoerkel
- 1 Thought Leadership and Innovation Foundation , McLean, VA
| | - Dawn Bellanti
- 1 Thought Leadership and Innovation Foundation , McLean, VA
| | - Charmagne Paat
- 1 Thought Leadership and Innovation Foundation , McLean, VA
| | - Kimberly Peacock
- 2 Department of Epidemiology & Biostatistics, University of Texas Health San Antonio , San Antonio, TX
| | - James Aden
- 3 Brooke Army Medical Center , Fort Sam Houston, TX
| | | | | | - Alice Inman
- 3 Brooke Army Medical Center , Fort Sam Houston, TX
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Bay E, Chan RR. Mindfulness-Based Versus Health Promotion Group Therapy After Traumatic Brain Injury. J Psychosoc Nurs Ment Health Serv 2018; 57:26-33. [PMID: 30272810 DOI: 10.3928/02793695-20180924-03] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 06/08/2018] [Indexed: 01/15/2023]
Abstract
The current pre- and posttest intervention study is designed for individuals with chronic symptoms and stress associated with mild-to-moderate traumatic brain injury (TBI). The researchers' intent was to evaluate whether an 8-week mindfulness-based group therapy compared to health promotion active control group therapy reduces chronic stress, TBI symptoms, and depressive symptoms. Significant mean reductions in chronic stress and TBI depressive and general symptoms for individuals in the mindfulness group compared to the active control group were present, according to paired t test analyses. Further, while controlling for baseline scores, the mindfulness-based intervention group change score was greater compared to the control group using regression analyses. Results suggest that mindfulness-based group intervention for individuals with chronic difficulties after TBI is feasible and effective. Further study of this cost-effective and self-management approach to stress and symptom management is warranted and has the potential to be a broad-based intervention for early therapy after injury. [Journal of Psychosocial Nursing and Mental Health Services, 57(1), 26-33.].
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Haut SR, Lipton RB, Cornes S, Dwivedi AK, Wasson R, Cotton S, Strawn JR, Privitera M. Behavioral interventions as a treatment for epilepsy: A multicenter randomized controlled trial. Neurology 2018; 90:e963-e970. [PMID: 29444968 DOI: 10.1212/wnl.0000000000005109] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 12/11/2017] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To evaluate the effect of a stress-reduction intervention in participants with medication-resistant epilepsy. METHODS Adults with medication-resistant focal epilepsy (n = 66) were recruited from 3 centers and randomized to 1 of 2 interventions: (1) progressive muscle relaxation (PMR) with diaphragmatic breathing, or (2) control focused-attention activity with extremity movements. Following an 8-week baseline period, participants began 12 weeks of double-blind treatment. Daily self-reported mood and stress ratings plus seizure counts were completed by participants using an electronic diary, and no medication adjustments were permitted. The primary outcome was percent reduction in seizure frequency per 28 days comparing baseline and treatment; secondary outcomes included stress reduction and stress-seizure interaction. RESULTS In the 66 participants in the intention-to-treat analysis, seizure frequency was reduced from baseline in both treatment groups (PMR: 29%, p < 0.05; focused attention: 25%, p < 0.05). PMR and focused attention did not differ in seizure reduction (p = 0.38), although PMR was associated with stress reduction relative to focused attention (p < 0.05). Daily stress was not a predictor of seizures. CONCLUSIONS Both PMR and the focused-attention groups showed reduced seizure frequency compared to baseline in participants with medication-resistant focal seizures, although the 2 treatments did not differ. PMR was more effective than focused attention in reducing self-reported stress. CLINICALTRIALSGOV IDENTIFIER NCT01444183.
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Affiliation(s)
- Sheryl R Haut
- From Montefiore-Einstein Epilepsy Center (S.R.H.) and Departments of Neurology (S.R.H., R.B.L.) and Epidemiology and Population Health (R.B.L.), Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; University of California (S. Cornes), San Francisco, CA; Division of Biostatistics & Epidemiology (A.K.D.), Department of Biomedical Sciences, Paul L. Foster School of Medicine and Biostatistics & Epidemiology Consulting Lab, Office of Research Resources, Texas Tech University Health Sciences Center, El Paso, TX; and Departments of Family and Community Medicine (R.W.), Integrative Medicine UC Cancer Institute (S. Cotton), Psychiatry and Behavioral Neuroscience (J.R.S.), and Neurology (M.P.), University of Cincinnati College of Medicine, OH.
| | - Richard B Lipton
- From Montefiore-Einstein Epilepsy Center (S.R.H.) and Departments of Neurology (S.R.H., R.B.L.) and Epidemiology and Population Health (R.B.L.), Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; University of California (S. Cornes), San Francisco, CA; Division of Biostatistics & Epidemiology (A.K.D.), Department of Biomedical Sciences, Paul L. Foster School of Medicine and Biostatistics & Epidemiology Consulting Lab, Office of Research Resources, Texas Tech University Health Sciences Center, El Paso, TX; and Departments of Family and Community Medicine (R.W.), Integrative Medicine UC Cancer Institute (S. Cotton), Psychiatry and Behavioral Neuroscience (J.R.S.), and Neurology (M.P.), University of Cincinnati College of Medicine, OH
| | - Susannah Cornes
- From Montefiore-Einstein Epilepsy Center (S.R.H.) and Departments of Neurology (S.R.H., R.B.L.) and Epidemiology and Population Health (R.B.L.), Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; University of California (S. Cornes), San Francisco, CA; Division of Biostatistics & Epidemiology (A.K.D.), Department of Biomedical Sciences, Paul L. Foster School of Medicine and Biostatistics & Epidemiology Consulting Lab, Office of Research Resources, Texas Tech University Health Sciences Center, El Paso, TX; and Departments of Family and Community Medicine (R.W.), Integrative Medicine UC Cancer Institute (S. Cotton), Psychiatry and Behavioral Neuroscience (J.R.S.), and Neurology (M.P.), University of Cincinnati College of Medicine, OH
| | - Alok K Dwivedi
- From Montefiore-Einstein Epilepsy Center (S.R.H.) and Departments of Neurology (S.R.H., R.B.L.) and Epidemiology and Population Health (R.B.L.), Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; University of California (S. Cornes), San Francisco, CA; Division of Biostatistics & Epidemiology (A.K.D.), Department of Biomedical Sciences, Paul L. Foster School of Medicine and Biostatistics & Epidemiology Consulting Lab, Office of Research Resources, Texas Tech University Health Sciences Center, El Paso, TX; and Departments of Family and Community Medicine (R.W.), Integrative Medicine UC Cancer Institute (S. Cotton), Psychiatry and Behavioral Neuroscience (J.R.S.), and Neurology (M.P.), University of Cincinnati College of Medicine, OH
| | - Rachel Wasson
- From Montefiore-Einstein Epilepsy Center (S.R.H.) and Departments of Neurology (S.R.H., R.B.L.) and Epidemiology and Population Health (R.B.L.), Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; University of California (S. Cornes), San Francisco, CA; Division of Biostatistics & Epidemiology (A.K.D.), Department of Biomedical Sciences, Paul L. Foster School of Medicine and Biostatistics & Epidemiology Consulting Lab, Office of Research Resources, Texas Tech University Health Sciences Center, El Paso, TX; and Departments of Family and Community Medicine (R.W.), Integrative Medicine UC Cancer Institute (S. Cotton), Psychiatry and Behavioral Neuroscience (J.R.S.), and Neurology (M.P.), University of Cincinnati College of Medicine, OH
| | - Sian Cotton
- From Montefiore-Einstein Epilepsy Center (S.R.H.) and Departments of Neurology (S.R.H., R.B.L.) and Epidemiology and Population Health (R.B.L.), Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; University of California (S. Cornes), San Francisco, CA; Division of Biostatistics & Epidemiology (A.K.D.), Department of Biomedical Sciences, Paul L. Foster School of Medicine and Biostatistics & Epidemiology Consulting Lab, Office of Research Resources, Texas Tech University Health Sciences Center, El Paso, TX; and Departments of Family and Community Medicine (R.W.), Integrative Medicine UC Cancer Institute (S. Cotton), Psychiatry and Behavioral Neuroscience (J.R.S.), and Neurology (M.P.), University of Cincinnati College of Medicine, OH
| | - Jeffrey R Strawn
- From Montefiore-Einstein Epilepsy Center (S.R.H.) and Departments of Neurology (S.R.H., R.B.L.) and Epidemiology and Population Health (R.B.L.), Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; University of California (S. Cornes), San Francisco, CA; Division of Biostatistics & Epidemiology (A.K.D.), Department of Biomedical Sciences, Paul L. Foster School of Medicine and Biostatistics & Epidemiology Consulting Lab, Office of Research Resources, Texas Tech University Health Sciences Center, El Paso, TX; and Departments of Family and Community Medicine (R.W.), Integrative Medicine UC Cancer Institute (S. Cotton), Psychiatry and Behavioral Neuroscience (J.R.S.), and Neurology (M.P.), University of Cincinnati College of Medicine, OH
| | - Michael Privitera
- From Montefiore-Einstein Epilepsy Center (S.R.H.) and Departments of Neurology (S.R.H., R.B.L.) and Epidemiology and Population Health (R.B.L.), Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; University of California (S. Cornes), San Francisco, CA; Division of Biostatistics & Epidemiology (A.K.D.), Department of Biomedical Sciences, Paul L. Foster School of Medicine and Biostatistics & Epidemiology Consulting Lab, Office of Research Resources, Texas Tech University Health Sciences Center, El Paso, TX; and Departments of Family and Community Medicine (R.W.), Integrative Medicine UC Cancer Institute (S. Cotton), Psychiatry and Behavioral Neuroscience (J.R.S.), and Neurology (M.P.), University of Cincinnati College of Medicine, OH
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Garnett A, Ploeg J, Markle-Reid M, Strachan PH. Self-Management of Multiple Chronic Conditions by Community-Dwelling Older Adults: A Concept Analysis. SAGE Open Nurs 2018; 4:2377960817752471. [PMID: 33415188 PMCID: PMC7774451 DOI: 10.1177/2377960817752471] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 11/29/2017] [Accepted: 12/10/2017] [Indexed: 11/16/2022] Open
Abstract
The proportion of the aging population living with multiple chronic conditions (MCC) is increasing. Self-management is valuable in helping individuals manage MCC. The purpose of this study was to conduct a concept analysis of self-management in community-dwelling older adults with MCC using Walker and Avant's method. The review included 30 articles published between 2000 and 2017. The following attributes were identified: (a) using financial resources for chronic disease management, (b) acquiring health- and disease-related education, (c) making use of ongoing social supports, (d) responding positively to health changes, (e) ongoing engagement with the health system, and (f) actively participating in sustained disease management. Self-management is a complex process; the presence of these attributes increases the likelihood that an older adult will be successful in managing the symptoms of MCC.
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Affiliation(s)
- Anna Garnett
- Aging, Community and Health Research Unit, School of Nursing, McMaster University, Hamilton, ON, Canada
- School of Nursing, McMaster University, Hamilton, ON, Canada
| | - Jenny Ploeg
- Aging, Community and Health Research Unit, School of Nursing, McMaster University, Hamilton, ON, Canada
- School of Nursing, McMaster University, Hamilton, ON, Canada
| | - Maureen Markle-Reid
- Aging, Community and Health Research Unit, School of Nursing, McMaster University, Hamilton, ON, Canada
- School of Nursing, McMaster University, Hamilton, ON, Canada
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Mehling WE, Chesney MA, Metzler TJ, Goldstein LA, Maguen S, Geronimo C, Agcaoili G, Barnes DE, Hlavin JA, Neylan TC. A 12-week integrative exercise program improves self-reported mindfulness and interoceptive awareness in war veterans with posttraumatic stress symptoms. J Clin Psychol 2017; 74:554-565. [DOI: 10.1002/jclp.22549] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Revised: 08/20/2017] [Accepted: 09/01/2017] [Indexed: 11/12/2022]
Affiliation(s)
- Wolf E. Mehling
- University of California; San Francisco USA
- San Francisco Veterans Affairs Medical Center
| | - Margaret A. Chesney
- University of California; San Francisco USA
- San Francisco Veterans Affairs Medical Center
| | - Thomas J. Metzler
- University of California; San Francisco USA
- San Francisco Veterans Affairs Medical Center
| | - Lizabeth A. Goldstein
- University of California; San Francisco USA
- San Francisco Veterans Affairs Medical Center
| | - Shira Maguen
- University of California; San Francisco USA
- San Francisco Veterans Affairs Medical Center
| | | | | | - Deborah E. Barnes
- University of California; San Francisco USA
- San Francisco Veterans Affairs Medical Center
| | | | - Thomas C. Neylan
- University of California; San Francisco USA
- San Francisco Veterans Affairs Medical Center
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Arsova S, Manusheva N, Kopacheva-Barsova G, Bajraktarov S. Enduring Personality Changes after Intense Stressful Event: Case Report. Open Access Maced J Med Sci 2016; 4:453-454. [PMID: 27703573 PMCID: PMC5042633 DOI: 10.3889/oamjms.2016.083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 07/09/2016] [Accepted: 07/28/2016] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND World statistical data show that a large number of individuals suffer from posttraumatic stress disorder (PTSD) after exposure to the intense traumatic event. PTSD can have a chronic course with enduring changes in the functioning of the person. CASE PRESENTATION Here we report two adult individuals of different gender and education who were exposed to the extremely severe stressful event after which difficulties in psychological functioning developed. The first case we present is a 46-year-old man, with completed high education, divorced, father of two children, who lives with his parents, and is retired. Disorders appeared 20 years ago when he was exposed to extremely severe stressful events in war circumstances that included captivity, torture, and loss of fellow soldiers. The second case is a 50-year-old female patient, with a university degree, professor of art, married, and mother of two children of whom the son died six years ago. She suffered from disorders after the sudden injury of her son that ended with his death. CONCLUSION Posttraumatic stress disorder after the intense stress is a risk of development enduring personality changes with serious individual and social consequences.
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Affiliation(s)
- Slavica Arsova
- University Psychiatry Clinic, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Nensi Manusheva
- University Psychiatry Clinic, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Gabriela Kopacheva-Barsova
- University Clinic for Ear, Nose and Throat, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Vodnjanska 17, Skopje 1109, Republic of Macedonia
| | - Stojan Bajraktarov
- University Psychiatry Clinic, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
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Pelka M, Kölling S, Ferrauti A, Meyer T, Pfeiffer M, Kellmann M. Acute effects of psychological relaxation techniques between two physical tasks. J Sports Sci 2016; 35:216-223. [DOI: 10.1080/02640414.2016.1161208] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Crawford C, Boyd C, Jain S, Khorsan R, Jonas W. Rapid Evidence Assessment of the Literature (REAL(©)): streamlining the systematic review process and creating utility for evidence-based health care. BMC Res Notes 2015; 8:631. [PMID: 26525982 PMCID: PMC4630849 DOI: 10.1186/s13104-015-1604-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Accepted: 10/19/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Systematic reviews (SRs) are widely recognized as the best means of synthesizing clinical research. However, traditional approaches can be costly and time-consuming and can be subject to selection and judgment bias. It can also be difficult to interpret the results of a SR in a meaningful way in order to make research recommendations, clinical or policy decisions, or practice guidelines. Samueli Institute has developed the Rapid Evidence Assessment of the Literature (REAL) SR process to address these issues. REAL provides up-to-date, rigorous, high quality SR information on health care practices, products, or programs in a streamlined, efficient and reliable manner. This process is a component of the Scientific Evaluation and Review of Claims in Health Care (SEaRCH™) program developed by Samueli Institute, which aims at answering the question of "What works?" in health care. METHODS/DESIGN The REAL process (1) tailors a standardized search strategy to a specific and relevant research question developed with various stakeholders to survey the available literature; (2) evaluates the quantity and quality of the literature using structured tools and rulebooks to ensure objectivity, reliability and reproducibility of reviewer ratings in an independent fashion and; (3) obtains formalized, balanced input from trained subject matter experts on the implications of the evidence for future research and current practice. RESULTS Online tools and quality assurance processes are utilized for each step of the review to ensure a rapid, rigorous, reliable, transparent and reproducible SR process. CONCLUSIONS The REAL is a rapid SR process developed to streamline and aid in the rigorous and reliable evaluation and review of claims in health care in order to make evidence-based, informed decisions, and has been used by a variety of organizations aiming to gain insight into "what works" in health care. Using the REAL system allows for the facilitation of recommendations on appropriate next steps in policy, funding, and research and for making clinical and field decisions in a timely, transparent, and cost-effective manner.
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Affiliation(s)
- Cindy Crawford
- Samueli Institute, 1737 King Street, Suite 600, Alexandria, VA, 22314, USA.
| | - Courtney Boyd
- Samueli Institute, 1737 King Street, Suite 600, Alexandria, VA, 22314, USA.
| | - Shamini Jain
- Samueli Institute, 2101 East Coast Hwy., Suite 300, Corona del Mar, CA, 92625, USA.
| | - Raheleh Khorsan
- Samueli Institute, 2101 East Coast Hwy., Suite 300, Corona del Mar, CA, 92625, USA.
| | - Wayne Jonas
- Samueli Institute, 1737 King Street, Suite 600, Alexandria, VA, 22314, USA.
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Jain S, Boyd C, Fiorentino L, Khorsan R, Crawford C. Are there efficacious treatments for treating the fatigue-sleep disturbance-depression symptom cluster in breast cancer patients? A Rapid Evidence Assessment of the Literature (REAL(©)). BREAST CANCER-TARGETS AND THERAPY 2015; 7:267-91. [PMID: 26379445 PMCID: PMC4567232 DOI: 10.2147/bctt.s25014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Purpose While fatigue, sleep disturbance, and depression often co-occur in breast cancer patients, treatment efficacy for this symptom cluster is unknown. A systematic review was conducted to determine whether there are specific interventions (ie, medical, pharmacological, behavioral, psychological, and complementary medicine approaches) that are effective in mitigating the fatigue–sleep disturbance–depression symptom cluster in breast cancer patients, using the Rapid Evidence Assessment of the Literature (REAL©) process. Methods Peer-reviewed literature was searched across multiple databases; from database inception – October 2011, using keywords pre-identified to capture randomized controlled trials (RCT) relevant to the research question. Methodological bias was assessed using the Scottish Intercollegiate Guidelines Network (SIGN) 50 checklist. Confidence in the estimate of effect and assessment of safety were also evaluated across the categories of included interventions via the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) methodology. Results The initial search yielded 531 citations, of which 41 met the inclusion criteria. Of these, twelve RCTs reported on all three symptoms, and eight of these were able to be included in the GRADE analysis. The remaining 29 RCTs reported on two symptoms. Studies were of mixed quality and many were underpowered. Overall, results suggest that there is: 1) promising evidence for the effectiveness of various treatment types in mitigating sleep disturbance in breast cancer patients; 2) mixed evidence for fatigue; 3) little evidence for treating depression; and 4) no clear evidence that treatment of one symptom results in effective treatment for other symptoms. Conclusion More high-quality studies are needed to determine the impact of varied treatments in mitigating the fatigue–sleep disturbance–depression symptom cluster in breast cancer patients. Furthermore, we encourage future studies to examine the psychometric and clinical validity of the hypothesized relationship between the symptoms in the fatigue–sleep disturbance–depression symptom cluster.
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Affiliation(s)
- Shamini Jain
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | | | - Lavinia Fiorentino
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
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Jallo N, Salyer J, Ruiz RJ, French E. Perceptions of guided imagery for stress management in pregnant African American women. Arch Psychiatr Nurs 2015; 29:249-54. [PMID: 26165981 DOI: 10.1016/j.apnu.2015.04.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Revised: 03/28/2015] [Accepted: 04/11/2015] [Indexed: 10/23/2022]
Abstract
Maternal stress during pregnancy has been associated with numerous adverse pregnancy, birth, and health outcomes. Pregnant African American women have been reported to have higher levels of stress compared to other ethnic or racial groups underscoring the need for effective interventions to reduce stress in this population. The purpose of this study was to gain an in-depth understanding of the perceptions of guided imagery (GI) as a technique for stress management in a cohort of pregnant African American women who participated in a GI intervention as part of a larger mixed methods randomized controlled trial. The 12week intervention was a professionally recorded compact disc with four tracks developed and sequenced to reduce stress and associated symptoms. The findings from this descriptive phenomenologic study were derived from daily logs and interviews from 36 participants randomized to the GI group. Participants described the stressful nature of their lives. Results demonstrated pregnant African American women perceived the intervention as beneficial in reducing stress and the associated symptoms. The emergent themes suggested the intervention offered a respite from their stressful lives, reduced the negative emotional responses to stress and enhanced well-being, benefited other areas of their daily life, and provided an opportunity to connect with their baby. The study results support the perceived efficacy of GI as a stress coping intervention. GI is an economic as well as easy to implement, access and use technique that has potential stress coping benefits as perceived by pregnant African American women.
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Affiliation(s)
- Nancy Jallo
- Virginia Commonwealth University, School of Nursing, Richmond, VA.
| | - Jeanne Salyer
- Virginia Commonwealth University, School of Nursing, Richmond, VA.
| | - R Jeanne Ruiz
- Research and Faculty Scholarship, Texas Tech University, Gayle Greve Hunt School of Nursing, El Paso, TX.
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Abstract
Military service differs from civilian jobs in the stressors that service members experience, including frequent deployments (eg, to an area of combat operations), obedience, regimentation, subordination of self to the group, integrity, and flexibility. The military culture emphasizes teamwork and peer support. In some cases, service members cannot adapt to military life, become overwhelmed by stress, or cannot overcome a traumatic experience. Clinicians should conduct a thorough evaluation guided by an understanding of the military culture. Every effort should be made to identify the stress and the maladaptive response and provide early clinical interventions to prevent progression.
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Affiliation(s)
- R Gregory Lande
- Medical Corps (RET), US Army, USA; Psychiatry Continuity Service, Department of Psychiatry, Walter Reed National Military Medical Center, Building 8, 4th Floor, 8901 Wisconsin Avenue, Bethesda, MD 20889-5600, USA.
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