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Schläpfer S, Astakhov G, Pawel S, Eicher M, Kowatsch T, Held L, Witt CM, Barth J. Effects of app-based relaxation techniques on perceived momentary relaxation: Observational data analysis in people with cancer. J Psychosom Res 2024; 184:111864. [PMID: 39067182 DOI: 10.1016/j.jpsychores.2024.111864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 07/02/2024] [Accepted: 07/21/2024] [Indexed: 07/30/2024]
Abstract
OBJECTIVE To examine the effects of six relaxation techniques on perceived momentary relaxation and a possible association of relaxation effects with time and practice experience in people with cancer. METHODS We used data from participants with cancer in a larger study practicing app-based relaxation techniques over 10 weeks, assessed momentary relaxation before and after every third relaxation practice, and analyzed momentary relaxation changes with a linear mixed-effects model. RESULTS The sample included 611 before-after observations from 91 participants (70 females (76.9%)) with a mean age of 55.43 years (SD 10.88). We found moderate evidence for variations in momentary relaxation changes across different techniques (P = .026), with short meditation, mindfulness meditation, guided imagery, and progressive muscle relaxation more frequently observed and leading to more relaxation than body scan and walking meditation. Furthermore, we found moderate evidence for increasing momentary relaxation changes over time (P = .046), but no evidence for an association between momentary relaxation and the number of previous observations (proxy for practice experience; P = .47). CONCLUSION We compared six app-based relaxation techniques in a real-life setting of people with cancer. The observed variations in perceived momentary relaxation appear to correspond with the popularity of the techniques used: The most popular relaxation techniques were the most effective and the least popular were the least effective. The effects increased over time, likely caused by dropout of individuals who gained no immediate benefit. Our findings open an interesting avenue for future research to better understand which relaxation techniques work best for whom in which situations. TRIAL REGISTRATION DRKS00027546; https://drks.de/search/en/trial/DRKS00027546.
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Affiliation(s)
- Sonja Schläpfer
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
| | - George Astakhov
- Epidemiology, Biostatistics and Prevention Institute (EBPI), Center for Reproducible Science (CRS), University of Zurich, Zurich, Switzerland
| | - Samuel Pawel
- Epidemiology, Biostatistics and Prevention Institute (EBPI), Center for Reproducible Science (CRS), University of Zurich, Zurich, Switzerland
| | - Manuela Eicher
- IUFRS Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland; Department of Oncology, CHUV, Lausanne, Switzerland
| | - Tobias Kowatsch
- Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland; School of Medicine, University of St. Gallen, St. Gallen, Switzerland; Centre for Digital Health Interventions, Department of Management, Technology, and Economics at ETH Zurich, Zurich, Switzerland
| | - Leonhard Held
- Epidemiology, Biostatistics and Prevention Institute (EBPI), Center for Reproducible Science (CRS), University of Zurich, Zurich, Switzerland
| | - Claudia M Witt
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Jürgen Barth
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
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Tabib M, Humphrey T, Forbes-McKay K. The influence of antenatal relaxation classes on perinatal psychological wellbeing and childbirth experiences: a qualitative study. J Reprod Infant Psychol 2024:1-19. [PMID: 38895982 DOI: 10.1080/02646838.2024.2369937] [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: 02/22/2024] [Accepted: 06/13/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND There is growing evidence that antenatal education incorporating relaxation practices can positively influence perinatal psychological wellbeing. However, a paucity of qualitative research is evident. Gaining insight into how and why such education may influence childbearing women, can inform the design of effective educational interventions. This study aimed to explore the perspectives of women and their partners on how and why a single Antenatal Relaxation Class (ARC) might influence perinatal psychological wellbeing and childbirth experiences. METHOD In this descriptive qualitative study, 17 women and 9 partners participated in semi-structured in-depth interviews and the data were analysed using thematic analysis. The study was carried out in a Scottish NHS Health Board where ARC was provided to expectant parents. FINDINGS Two themes were generated, namely: 'the turning point', and 'recognition of an inner resource'. Participants perceived ARC as 'the turning point' when they became more confident, equipped, and less fearful and anxious towards childbirth. 'Understanding of the psychophysiological processes of childbirth', 'positive stories', and 'practice of relaxation techniques' were reported as the main reasons for these positive changes. Participants explained ARC had enabled them to access a deep sense of calmness as 'an inner resource' and motivated the use of relaxation techniques as a self-care behaviour throughout pregnancy and childbirth. CONCLUSION A single antenatal relaxation class has the potential to enhance perinatal psychological wellbeing and childbirth experiences. This study provides valuable insights for maternity services seeking to develop effective health-promoting antenatal education.
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Affiliation(s)
- Mo Tabib
- School of Nursing, Midwifery and Paramedic Practice, Robert Gordon University, Aberdeen, UK
| | - Tracy Humphrey
- Clinical and Health Sciences, University of South Australia, Adelaide, Australia
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Ukhawounam U, Limruangrong P, Pungbangkadee R, Vongsirimas N. Effects of Education and Guided Imagery Program on Stress Level and Coping Behaviors Among Pregnant Women at Risk of Preterm Birth. Int J Womens Health 2023; 15:1581-1591. [PMID: 37876759 PMCID: PMC10591644 DOI: 10.2147/ijwh.s418693] [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: 04/25/2023] [Accepted: 09/26/2023] [Indexed: 10/26/2023] Open
Abstract
Purpose The rate of preterm birth continues to increase worldwide. Pregnant women at risk of preterm birth experience more stress during pregnancy, which directly impacts their mental well-being and preterm birth situation. Stress management can significantly reduce stress and promote appropriate coping behaviors in pregnant women at risk of preterm birth. The purpose of this study was to determine the effects of education and guided imagery program on stress level and coping behaviors among pregnant women at risk of preterm birth. Patients and Methods Forty-eight pregnant women who visited the antenatal care unit at Ramathibodi Hospital and were at risk of preterm birth with moderate stress score were included. They were divided into two groups, each comprising 24 participants. The control group received standard nursing care, whereas the experimental group received an education and guided imagery program in addition to standard nursing care. The Perceived Stress Scale-10 and Coping Behavior Questionnaire were used to collect data. Results The results revealed that the mean stress score in the experimental group after receiving the program was lower than before with statistical significance (t = 7.14, p < 0.001). Moreover, the experimental group had lower stress score (F1,45 = 16.92, p < 0.001) and greater coping behavior score (F1,45 = 7.85, p < 0.01) compared with the control group after receiving the program, and the differences were statistically significant. Conclusion This research highlights the importance of preventing mental health problems in pregnant women at risk of preterm birth by using an education and guided imagery program to decrease stress and promote appropriate coping behaviors.
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Affiliation(s)
- Uraiwan Ukhawounam
- Master of Nursing Science Program in Midwifery, Faculty of Nursing, Mahidol University, Nakhonpathom, Thailand
| | - Piyanun Limruangrong
- Department of Obstetrics and Gynaecology Nursing, Faculty of Nursing, Mahidol University, Bangkok, Thailand
| | - Rudee Pungbangkadee
- Department of Obstetrics and Gynaecology Nursing, Faculty of Nursing, Mahidol University, Bangkok, Thailand
| | - Nopporn Vongsirimas
- Department of Mental Health and Psychiatric Nursing, Faculty of Nursing, Mahidol University, Nakhonpathom, Thailand
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Ağapınar Şahin S, Bekar M. The influence of laughter yoga on pregnancy symptoms, mental well-being, and prenatal attachment: A randomized controlled study. Health Care Women Int 2023; 44:782-801. [PMID: 36625775 DOI: 10.1080/07399332.2022.2164284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The researchers' aim was to evaluate the impact of laughter yoga on pregnancy symptoms, mental well-being, and prenatal attachment. They carried out this study on 85 pregnant women randomized in a maternity hospital in the Eastern Anatolia Region of Turkey. The researchers collected data using the Pregnant Introduction Form, Pregnancy Symptom Inventory (PSI), Warwick-Edinburgh Mental Well-being Scale (WEMWBS), and Prenatal Attachment Inventory (PAI). After applying the laughter yoga practice, they found that mental well-being and prenatal attachment levels were higher in pregnant women in the experimental group and the difference was statistically significant. Thus, they concluded that laughter yoga was an effective practice in reducing the frequency of pregnancy symptoms and limiting daily activities by pregnancy symptoms and increasing mental well-being and prenatal attachment levels.
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Affiliation(s)
- Safiye Ağapınar Şahin
- Department of Midwifery, Ataturk University Faculty of Health Science, Erzurum, Turkey
| | - Mine Bekar
- Faculty of Health Science, Department of Midwifery, Sivas Cumhuriyet University, Sivas, Turkey
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Wang X, Zhang J, Xin H, Tan W, Liu Y, Wan J. Effectiveness of two distraction strategies in reducing preoperative anxiety in children in China: A randomized controlled trial. J Pediatr Nurs 2023; 68:e8-e15. [PMID: 36402600 DOI: 10.1016/j.pedn.2022.10.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 10/23/2022] [Accepted: 10/23/2022] [Indexed: 11/18/2022]
Abstract
PURPOSE Music and animation are the most common and affordable distraction strategies to reduce preoperative anxiety in children; however, their effects are inconsistent. This study aimed to examine the effectiveness of two distraction strategies (music or animation) in reducing preoperative anxiety in children. DESIGN AND METHODS In this randomized controlled trial, 183 children who underwent surgery were divided into music, animation, and control groups using a single-blind block randomized design. Children in the control group underwent routine preoperative visits. Meanwhile, the children in the intervention groups could choose their favorite music and cartoons as intervention content. Study outcomes included anxiety levels, degree of cooperation, heart rate, and blood pressure. Data were collected before entering the operating room, entering the operating room, and before the induction of anesthesia; only the degree of cooperation was collected before the induction of anesthesia. RESULTS Only animation significantly reduced preoperative anxiety in the children (P < 0.05) upon entering the operating room. Both music and animation reduced the level of preoperative anxiety before induction of anesthesia; however, there was no significant difference between them (P > 0.05). The induction compliance score was significantly lower in the music and animation groups than in the control group (P < 0.05). Heart rates differed significantly between the three groups from before entering the operating room to before induction of anesthesia. Children in the control group had the highest systolic blood pressure upon entering the operating room (P < 0.05). CONCLUSIONS Music and animation strategies can significantly reduce preoperative anxiety in children and improve surgical cooperation during anesthesia induction. TRIAL REGISTRATION Clinical. TRIALS gov NCT05285995.
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Affiliation(s)
- Xiao Wang
- The Third Xiangya Hospital of Central South University, Changsha 410013, China
| | - Jie Zhang
- School of nursing, Hunan University of Chinese Medicine, Changsha 410208, China
| | - He Xin
- The Third Xiangya Hospital of Central South University, Changsha 410013, China
| | - Wenhong Tan
- The Third Xiangya Hospital of Central South University, Changsha 410013, China
| | - Yinghong Liu
- The Third Xiangya Hospital of Central South University, Changsha 410013, China
| | - Jingjing Wan
- The Third Xiangya Hospital of Central South University, Changsha 410013, China.
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Silverwood VA, Bullock L, Turner K, Chew-Graham CA, Kingstone T. The approach to managing perinatal anxiety: A mini-review. Front Psychiatry 2022; 13:1022459. [PMID: 36590629 PMCID: PMC9797985 DOI: 10.3389/fpsyt.2022.1022459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 11/23/2022] [Indexed: 12/23/2022] Open
Abstract
Perinatal Anxiety (PNA) is defined as anxiety occurring during pregnancy and up to 12 months post-partum and is estimated to affect up to 20% of women. Risk factors for PNA are multiple and can be classed as psychological, social and biological. PNA negatively impacts on the mother, child and family. PNA is not well-recognized and diagnosis of PNA can be challenging for clinicians. There is currently no validated case-finding or diagnostic test available for PNA. PNA has been less extensively researched than perinatal depression (PND). Clinical guidance currently recommends pharmacological and psychological therapies for the management of women with PNA, however the limited research available suggests that other intervention types may also be effective with some evidence on the effectiveness of non-pharmacological interventions in primary care for PNA. This article provides a mini-review of PNA, summarizing current evidence around PNA including risk factors, the impact of PNA, the process of diagnosis of PNA and focussing predominantly on available management options for PNA.
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Affiliation(s)
| | - Laurna Bullock
- School of Medicine, Keele University, Staffordshire, United Kingdom
| | - Katrina Turner
- Centre of Academic Primary Health Care, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Carolyn A. Chew-Graham
- School of Medicine, Keele University, Staffordshire, United Kingdom
- Midlands Partnership NHS Foundation Trust, Trust Headquarters, St George's Hospital, Stafford, United Kingdom
- Applied Research Collaboration (ARC) West Midlands, Keele University, Staffordshire, United Kingdom
| | - Tom Kingstone
- School of Medicine, Keele University, Staffordshire, United Kingdom
- Midlands Partnership NHS Foundation Trust, Trust Headquarters, St George's Hospital, Stafford, United Kingdom
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Pile V, Williamson G, Saunders A, Holmes EA, Lau JYF. Harnessing emotional mental imagery to reduce anxiety and depression in young people: an integrative review of progress and promise. Lancet Psychiatry 2021; 8:836-852. [PMID: 34419188 DOI: 10.1016/s2215-0366(21)00195-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 04/23/2021] [Accepted: 05/12/2021] [Indexed: 11/15/2022]
Abstract
Emotional mental imagery is a powerful part of our mental landscape. Given its capacity to depict, process, and generate emotional events, mental imagery could have an important role in psychological therapies. This Series paper explores whether harnessing emotional mental imagery is meaningful to young people; ways in which interventions use emotional mental imagery; contextual and individual factors influencing intervention effectiveness; and mechanisms underpinning imagery techniques. We completed a systematic review of imagery interventions and consulted young people with lived experience (n=10) and leading international experts (n=7). The systematic search identified 86 papers covering a diverse range of imagery interventions. Across the seven categories of techniques reviewed, imagery rescripting for aversive memories, techniques targeting positive imagery, and imagery-enhanced protocols indicated the most potential. The report suggests that harnessing emotional mental imagery in psychological interventions could be a promising approach to reduce anxiety and depression and that mental health science could inform the development of new interventions and help to maximise intervention effectiveness.
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Affiliation(s)
- Victoria Pile
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Department of Psychology, Royal Holloway, University of London, Egham, UK.
| | - Grace Williamson
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Aleks Saunders
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Emily A Holmes
- Department of Psychology, Uppsala University, Uppsala, Sweden; Division of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Jennifer Y F Lau
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Identifying Patterns of Symptom Distress in Pregnant Women: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126333. [PMID: 34208074 PMCID: PMC8296154 DOI: 10.3390/ijerph18126333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 06/02/2021] [Accepted: 06/09/2021] [Indexed: 11/16/2022]
Abstract
During pregnancy, a woman's enlarged uterus and the developing fetus lead to symptom distress; in turn, physical and psychological aspects of symptom distress are often associated with adverse prenatal and birth outcomes. This study aimed to identify the trends in the trajectory of these symptoms. This longitudinal study recruited 95 pregnant women, with a mean age of 32 years, from the prenatal wards of two teaching hospitals in northern Taiwan. Symptom distress was measured by a 22-item scale related to pregnancy-induced symptoms. The follow-up measurements began during the first trimester and were taken every two to four weeks until childbirth. More than half of the pregnant women experienced symptom distress manifested in a pattern depicted to be "Decreased then Increased" (56.8%). Other noticeable patterns were "Continuously Increased" (28.4%), "Increased then Decreased" (10.5%) and "Continuously Decreased" (4.2%), respectively. It is worth noting that most pregnant women recorded a transit and increase in their symptom distress, revealed by their total scores, at the second trimester (mean 22.02 weeks) of pregnancy. The participants' major pregnancy-related distress symptoms were physical and included fatigue, frequent urination, lower back pain, and difficulty sleeping. The mean scores for individual symptoms ranged from 2.32 to 3.61 and were below the "moderately distressful" level. This study provides evidence that could be used to predict women's pregnancy-related symptom distress and help healthcare providers implement timely interventions to improve prenatal care.
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Gordon JS, Bell ML, Armin JS, Giacobbi PR, Nair US. A telephone-based guided imagery tobacco cessation intervention: results of a randomized feasibility trial. Transl Behav Med 2021; 11:516-529. [PMID: 32542352 PMCID: PMC7963280 DOI: 10.1093/tbm/ibaa052] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Evidence supports the use of guided imagery for smoking cessation; however, scalable delivery methods are needed to make it a viable approach. Telephone-based tobacco quitlines are a standard of care, but reach is limited. Adding guided imagery to quitline services might increase reach by offering an alternative approach. PURPOSE To develop and test the feasibility and potential impact of a guided imagery-based tobacco cessation intervention delivered using a quitline model. METHODS Participants for this randomized feasibility trial were recruited statewide through a quitline or community-based methods. Participants were randomized to guided imagery Intervention Condition (IC) or active behavioral Control Condition (CC). After withdrawals, there were 105 participants (IC = 56; CC = 49). The IC consisted of six sessions in which participants created guided imagery audio files. The CC used a standard six-session behavioral protocol. Feasibility measures included recruitment rate, retention, and adherence to treatment. We also assessed 6-month quit rates and consumer satisfaction. RESULTS Both the IC and CC protocols were feasible to deliver. We finalized protocols and materials for participants, coaches and study staff, and delivered the protocols with fidelity. We developed successful recruitment methods, and experienced high retention (6 months = 81.9%) and adherence (all sessions = 66.7%). Long-term quit rates (IC = 27.9%; CC = 38.1%) compared favorably to those of quitlines, and program satisfaction was high, suggesting that the protocols are acceptable to smokers and may contribute to smoking abstinence. CONCLUSIONS The guided imagery intervention is feasible and promising, suggesting that a fully powered RCT to test the efficacy of the intervention is warranted. TRIAL REGISTRATION NUMBER NCT02968381.
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Affiliation(s)
| | - Melanie L Bell
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Julie S Armin
- Department of Family and Community Medicine, University of Arizona, Tucson, AZ, USA
| | - Peter R Giacobbi
- College of Physical Activity and Sport Sciences and School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Uma S Nair
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
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Abasi E, Keramat A, Borghei NS, Goli S, Farjamfar M. Evaluating the effect of prenatal interventions on maternal-foetal attachment: A systematic review and meta-analysis. Nurs Open 2021; 8:4-16. [PMID: 33318807 PMCID: PMC7729675 DOI: 10.1002/nop2.648] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 08/25/2020] [Accepted: 09/08/2020] [Indexed: 11/10/2022] Open
Abstract
Aim This study aimed to evaluate the effect of prenatal interventions on maternal foetal attachment. Design Systematic review and meta-analysis. Methods In this study, a comprehensive review was performed to find articles published from January 2000 - December 2019 in the form of randomized and non-randomized clinical trials. To this end, online databases including PubMed, Scopus, Google Scholar, ScienceDirect, Proquest, Ovid, CINAHL and JAMA were searched. Duplicate articles were also excluded using Endnote X7 Reference. The results were then analysed via RevMan 5.3 software. Results The results showed that foetal movement counting did not seem to be effective in increasing MFA by itself. But, this intervention alongside other attachment behaviours such as touching the belly and talking to foetus could enhance MFA. Therefore, the best interventions to improve MFA might be combined ones implemented in the form of counselling and training sessions.
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Affiliation(s)
- Elieh Abasi
- Student Research CommitteeSchool of Nursing and MidwiferyShahroud University of Medical SciencesShahroudIran
| | - Afsaneh Keramat
- Reproductive Studies and Women’s Health Research CenterShahroud University of Medical SciencesShahroudIran
| | - Narjes Sadat Borghei
- Counseling & Reproductive Health Research CenterMidwifery DepartmentGolestan University of Medical sciencesGorganIran
| | - Shahrbanoo Goli
- Department of EpidemiologyShahroud University of Medical SciencesShahroudIran
| | - Maryam Farjamfar
- Clinical Research Development UnitImam Hossein HospitalShahroud University of Medical SciencesShahroudIran
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Jallo N, Brown L, Elswick RK, Kinser P, Salisbury AL. Happiness in Pregnant African American Women: What Are the Biobehavioral Correlates? J Perinat Neonatal Nurs 2021; 35:19-28. [PMID: 33528183 DOI: 10.1097/jpn.0000000000000529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The detrimental effects of prenatal stress on maternal-infant well-being have been well established and highlight increased concern for pregnant African American women. Research supports the notion that positive emotions may have a beneficial impact on the stress process and outcomes. However, the data have been largely restricted to non-African American pregnant women. This study's purpose was to examine potential relationships of both positive (happiness) and negative (stress, anxiety, and depressive symptoms) emotions and pro-inflammatory cytokines (interleukins-1β, -6, -8, -12, -17, tumor necrosis factor, and interferon-γ) in 72 pregnant African American women for a more complete picture of the stress process in this at-risk population. Results of this exploratory secondary data analysis show strong positive correlations between negative emotions and strong negative correlations between happiness and negative emotions. Interleukin-8 was positively correlated with negative emotions and negatively correlated with happiness. Results show mean ratings of negative emotions were higher than previously reported with more heterogeneous samples, while happiness ratings were in the moderate range. Findings suggest that pregnant African American women may experience higher stress and depressive symptoms than women in more heterogeneous samples. However, moderate levels of happiness might contribute to buffering the stress response.
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Affiliation(s)
- Nancy Jallo
- Department of Family and Community Health Nursing, School of Nursing, Virginia Commonwealth University, Richmond (Drs Jallo, Brown, Elswick, and Kinser); Department of Biostatistics, School of Medicine, Virginia Commonwealth University, Richmond (Dr Elswick); Physical Medicine and Rehabilitation, School of Medicine, Virginia Commonwealth University, Richmond (Dr Kinser) School of Nursing, Virginia Commonwealth University, Richmond (Dr Salisbury)
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Guo P, Zhang X, Liu N, Wang J, Chen D, Sun W, Li P, Zhang W. Mind-body interventions on stress management in pregnant women: A systematic review and meta-analysis of randomized controlled trials. J Adv Nurs 2020; 77:125-146. [PMID: 33048358 DOI: 10.1111/jan.14588] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 07/29/2020] [Accepted: 08/07/2020] [Indexed: 12/17/2022]
Abstract
AIM To quantify the effect of mind-body interventions on stress in pregnant women. DESIGN A systematic review and meta-analysis of randomized controlled trials was performed. DATA SOURCES PubMed, Embase, CENTRAL, Web of Science and PsycINFO were searched from each database inception to January 2020. REVIEW METHODS Randomized controlled trials regarding mind-body interventions for stress in pregnant women were included. Methodological quality was evaluated using the Cochrane Collaboration 'Risk of Bias' tool and meta-analysis was performed via RevMan 5.3. Subgroup analysis and publication bias assessment were conducted. Post hoc sensitivity analysis was performed to investigate the source of heterogeneity. RESULTS In total, 28 studies comprising 1944 participants were included. The overall meta-analysis showed that antenatal stress of pregnant women in the mind-body interventions groups showed significant high improvements (SMD=-0.94; 95% CI [-1.25, -0.63]; p < .00001) compared with the control groups. Results of subgroup analyses indicated that all types of mind-body interventions including mindfulness intervention, cognitive behavioural therapy, relaxation techniques and yoga were beneficial to antenatal stress. Both groups and individual formats mind-body interventions were effective. 4-8 weeks mind-body interventions were seemed as the optimal choice. Moreover, mind-body interventions were concomitant with reducing antenatal anxiety and depression. CONCLUSION Mind-body interventions are promising approaches for stress reduction in pregnant women. Nevertheless, the results should be interpreted with caution because of high heterogeneity and publication bias. Further high-quality studies are needed to verify the findings. IMPACT Mind-body interventions have been widely implemented to ameliorate antenatal stress, but conflicting results were found across studies. This systematic review and meta-analysis suggested that mind-body interventions are relatively safe and convenient and can successfully promote antenatal stress. The suggestions proposed in this review may be useful for developing a scientific mind-body interventions regimen and encouraging the application of mind-body interventions in pregnant women, thereby managing antenatal stress effectively.
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Affiliation(s)
- Pingping Guo
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Xuehui Zhang
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Na Liu
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Jie Wang
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Dandan Chen
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Weijia Sun
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Ping Li
- Department of Developmental Pediatrics, Second Hospital of Jilin University, Changchun, Jilin, China
| | - Wei Zhang
- School of Nursing, Jilin University, Changchun, Jilin, China
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Armin JS, Nair U, Giacobbi P, Povis G, Barraza Y, Gordon JS. Developing a Guided Imagery Telephone-Based Tobacco Cessation Program for a Randomized Controlled Trial. Tob Use Insights 2020; 13:1179173X20949267. [PMID: 32922107 PMCID: PMC7446272 DOI: 10.1177/1179173x20949267] [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: 01/08/2020] [Accepted: 07/14/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND/AIMS Guided imagery is an evidence-based, multi-sensory, cognitive process that can be used to increase motivation and achieve a desired behavior. Quitlines are effective, standard care approaches for tobacco cessation; however, utilization of quitlines is low. Using guided imagery-based interventions for smoking cessation may appeal to smokers who do not utilize traditional quitline services. This paper reports the development of program materials for a randomized controlled feasibility trial of a guided imagery-based smoking cessation intervention. The objective of the formative work was to ensure that program materials are inclusive of groups that are less likely to use quitlines, including men and racial/ethnic minority tobacco users. METHODS A three-phase process was used to complete formative assessment: (1) integration of evidence-based cessation practices into program development; (2) iterative small group interviews (N = 46) to modify the program; and (3) pilot-testing the coaching protocol and study process among a small sample of smokers (N = 5). RESULTS The Community Advisory Board and project consultants offered input on program content and study recruitment based on their knowledge of minority communities with whom they conduct outreach. Small group interview participants included members of underserved quitline populations (52.37% non-white; 55.56% men). Only 28.26% of participants had prior experience with guided imagery, but others described the use of similar mindfulness and meditation practices. Participant feedback was incorporated into program materials and protocols. DISCUSSION Iteratively collected feedback and pilot testing influenced program content and delivery and informed study processes for a randomized controlled feasibility trial of a telephone-delivered, guided imagery-based intervention.
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Affiliation(s)
- Julie S Armin
- Department of Family & Community Medicine, The University of Arizona College of Medicine, Tucson, AZ, USA
| | - Uma Nair
- Department of Family & Community Medicine, The University of Arizona College of Medicine, Tucson, AZ, USA
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, USA
| | - Peter Giacobbi
- College of Physical Activity and Sport Sciences and School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Gayle Povis
- The University of Arizona Collaboratory for Metabolic Disease Prevention and Treatment, Tucson AZ, USA
| | - Yessenya Barraza
- The University of Arizona Collaboratory for Metabolic Disease Prevention and Treatment, Tucson AZ, USA
| | - Judith S Gordon
- College of Nursing, The University of Arizona, Tucson, AZ, USA
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Ponting C, Mahrer NE, Zelcer H, Schetter CD, Chavira DA. Psychological interventions for depression and anxiety in pregnant Latina and Black women in the United States: A systematic review. Clin Psychol Psychother 2020; 27:249-265. [PMID: 31960525 PMCID: PMC7125032 DOI: 10.1002/cpp.2424] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 01/10/2020] [Indexed: 12/19/2022]
Abstract
Black women and Latinas have more symptoms of depression and anxiety during pregnancy than do their non-Latina White counterparts. Although effective interventions targeting internalizing disorders in pregnancy are available, they are primarily tested with White women. This article reviews randomized controlled trials and non-randomized studies to better understand the effectiveness of psychological interventions for anxiety and depression during pregnancy in Latinas and Black women. Additionally, this review summarizes important characteristics of interventions such as intervention format, treatment modality, and the use of cultural adaptations. Literature searches of relevant research citation databases produced 68 studies; 13 of which were included in the final review. Most studies were excluded because their samples were not majority Latina or Black women or because they did not test an intervention. Of the included studies, three interventions outperformed a control group condition and showed statistically significant reductions in depressive symptoms. An additional two studies showed reductions in depressive symptoms from pretreatment to post-treatment using non-controlled designs. The remaining eight studies (seven randomized and one non-randomized) did not show significant intervention effects. Cognitive behavioral therapy was the modality with most evidence for reducing depressive symptoms in pregnant Black and Latina women. No intervention was found to reduce anxiety symptoms, although only two of the 13 measured anxiety as an outcome. Five studies made cultural adaptations to their treatment protocols. Future studies should strive to better understand the importance of cultural modifications to improve engagement and clinical outcomes with pregnant women receiving treatment for anxiety and depression.
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Affiliation(s)
- Carolyn Ponting
- Department of Psychology, University of California, Los
Angeles. Los Angeles, CA
| | - Nicole E. Mahrer
- Department of Psychology, University of California, Los
Angeles. Los Angeles, CA
- Department of Psychology, University of La Verne, La Verne,
CA
| | - Hannah Zelcer
- Department of Psychology, University of California, Los
Angeles. Los Angeles, CA
| | | | - Denise A. Chavira
- Department of Psychology, University of California, Los
Angeles. Los Angeles, CA
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Yehia DBM, Malak MZ, Al-Thwabih NN, Awad RR, Al-Ajouri ES, Darwish SS, Hamad AS. Psychosocial factors correlate with fatigue among pregnant women in Jordan. Perspect Psychiatr Care 2020; 56:46-53. [PMID: 30887537 DOI: 10.1111/ppc.12372] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 02/17/2019] [Accepted: 03/01/2019] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The study aimed to assess the correlation between fatigue and psychological factors, namely stress, social support, self-esteem, and depression among pregnant women in Jordan. DESIGN AND METHODS A cross-sectional design was suggested. Cluster stratified random sampling technique was adopted. Fatigue assessment scale, Rosenberg Self-Esteem Scale, Perceived Stress Scale, Multidimensional Social Support Scale, and Beck's Depression Inventory were used. FINDINGS A total of 580 pregnant women were included. Overall, 67.4% of the participants experienced fatigue, about 74.0% had moderate to high stress, 56.0% had moderate social support, around 89.0% had normal self-esteem, and 43.1% experienced moderate to extreme depression. Stress, self-esteem, and depression were correlated with fatigue. PRACTICE IMPLICATIONS This study can help develop proper psychosocial care and sustain mental health among women during pregnancy.
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Affiliation(s)
- Dalal Bashir M Yehia
- Gynecology and Maternity Health Nursing, Faculty of Nursing, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Malakeh Z Malak
- Community Health Nursing, Faculty of Nursing, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Nancy N Al-Thwabih
- Adult Health Nursing, Marj Al-Hamam Health Center, Ministry of Health, Amman, Jordan
| | - Rawan R Awad
- Adult Health Nursing, Al-jweida Health Center, Ministry of Health, Amman, Jordan
| | - Enas S Al-Ajouri
- Adult Health Nursing, Faculty of Nursing, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Sarah S Darwish
- Adult Health Nursing, Faculty of Nursing, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Amnah S Hamad
- Health Education, Faculty of Nursing, Al-Zaytoonah University of Jordan, Amman, Jordan
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Levens SM, Sagui-Henson SJ, Padro M, Martin LE, Trucco EM, Cooperman NA, Baldwin AS, Kassianos AP, Mdege ND. The Effects of Positive Affect and Episodic Future Thinking on Temporal Discounting and Healthy Food Demand and Choice Among Overweight and Obese Individuals: Protocol for a Pilot 2×2 Factorial Randomized Controlled Study. JMIR Res Protoc 2019; 8:e12265. [PMID: 30892273 PMCID: PMC6446151 DOI: 10.2196/12265] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Revised: 11/16/2018] [Accepted: 12/10/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Unhealthy behaviors (eg, poor food choices) contribute to obesity and numerous negative health outcomes, including multiple types of cancer and cardiovascular and metabolic diseases. To promote healthy food choice, diet interventions should build on the dual-system model to target the regulation and reward mechanisms that guide eating behavior. Episodic future thinking (EFT) has been shown to strengthen regulation mechanisms by reducing unhealthy food choice and temporal discounting (TD), a process of placing greater value on smaller immediate rewards over larger future rewards. However, these interventions do not target the reward mechanisms that could support healthy eating and strengthen the impact of EFT-anchored programs. Increasing positive affect (PosA) related to healthy food choices may target reward mechanisms by enhancing the rewarding effects of healthy eating. An intervention that increases self-regulation regarding unhealthy foods and the reward value of healthy foods will likely have a greater impact on eating behavior compared with interventions focused on either process alone. OBJECTIVE This study aimed to introduce a protocol that tests the independent and interactive effects of EFT and PosA on TD, food choice, and food demand in overweight and obese adults. METHODS This protocol describes a factorial, randomized, controlled pilot study that employs a 2 (affective imagery: positive, neutral) by 2 (EFT: yes, no) design in which participants are randomized to 1 of 4 guided imagery intervention arms. In total, 156 eligible participants will complete 2 lab visits separated by 5 days. At visit 1, participants complete surveys; listen to the audio guided imagery intervention; and complete TD, food demand, and food choice tasks. At visit 2, participants complete TD, food demand, and food choice tasks and surveys. Participants complete a daily food frequency questionnaire between visits 1 and 2. Analyses will compare primary outcome measures at baseline, postintervention, and at follow-up across treatment arms. RESULTS Funding notification was received on April 27, 2017, and the protocol was approved by the institutional review board on October 6, 2017. Feasibility testing of the protocol was conducted from February 21, 2018, to April 18, 2018, among the first 32 participants. As no major protocol changes were required at the end of the feasibility phase, these 32 participants were included in the target sample of 156 participants. Recruitment, therefore, continued immediately after the feasibility phase. When this manuscript was submitted, 84 participants had completed the protocol. CONCLUSIONS Our research goal is to develop novel, theory-based interventions to promote and improve healthy decision-making and behaviors. The findings will advance decision-making research and have the potential to generate new neuroscience and psychological research to further understand these mechanisms and their interactions. TRIAL REGISTRATION ISRCTN Registry ISRCTN11704675; http://www.isrctn.com/ISRCTN11704675 (Archived by WebCite at http://www.webcitation.org/760ouOoKG). INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/12265.
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Affiliation(s)
- Sara M Levens
- University of North Carolina at Charlotte, Department of Psychological Science, Charlotte, NC, United States
| | - Sara J Sagui-Henson
- Osher Center for Integrative Medicine, University of California, San Francisco, San Fransisco, CA, United States
| | - Meagan Padro
- Department of Psychological Science, University of North Carolina at Charlotte, Charlotte, NC, United States
| | - Laura E Martin
- Hoglund Brain Imaging Center, University of Kansas Medical Center, Kansas City, KS, United States
| | - Elisa M Trucco
- Department of Psychology, Florida International University, Miami, FL, United States
| | - Nina A Cooperman
- Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, United States
| | - Austin S Baldwin
- Department of Psychology, Southern Methodist University, Dallas, TX, United States
| | - Angelos P Kassianos
- Department of Applied Health Research, University College London, London, United Kingdom
| | - Noreen D Mdege
- University of York, Department of Health Sciences, York, United Kingdom
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Beizaee Y, Rejeh N, Heravi-Karimooi M, Tadrisi SD, Griffiths P, Vaismoradi M. The effect of guided imagery on anxiety, depression and vital signs in patients on hemodialysis. Complement Ther Clin Pract 2018; 33:184-190. [DOI: 10.1016/j.ctcp.2018.10.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 10/06/2018] [Accepted: 10/16/2018] [Indexed: 10/28/2022]
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Abstract
PURPOSE To contribute to the treatment fidelity literature by providing real-world examples and suggestion for future research and potential clinical application, this article reports on implementation, assessment, and evaluation of treatment fidelity in mind-body self-care approaches in at-risk women. METHOD Aligning with best practices, treatment fidelity was integrated into three randomized clinical trials. The first examined the effects of a tai chi intervention designed to decrease cardiometabolic risk factors in women; the second examined the effects of a tailored guided imagery intervention on pregnancy outcomes in African American women; and the third explored effects of a mindful physical activity intervention (yoga) on psychological outcomes in women with moderate to severe depressive symptoms. FINDINGS Each of the studies successfully designed, implemented, and evaluated strategies to address recommended treatment fidelity components. These strategies provided qualitative and quantitative data that informed intervention refinement, directions for future research, and application in clinical practice. CONCLUSIONS The treatment fidelity framework used here is based on best practices and was a feasible and reliable approach for ensuring and reporting on treatment fidelity, which is contributing to future research to foster translation of potentially effective mind-body self-care approaches into practice.
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Chen X, Gong X, Shi C, Sun L, Tang Z, Yuan Z, Wang J, Yu J. Multi-focused psychosocial residential rehabilitation interventions improve quality of life among cancer survivors: a community-based controlled trial. J Transl Med 2018; 16:250. [PMID: 30189876 PMCID: PMC6127902 DOI: 10.1186/s12967-018-1618-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Accepted: 08/24/2018] [Indexed: 01/03/2023] Open
Abstract
Background Even though multi-focused psychosocial residence rehabilitation intervention (MPRRI) programs are widely implemented by the Shanghai Cancer Rehabilitation Club, these programs have not been rigorously evaluated. In this study, we evaluated the effects of a 21-day MPRRI program, on the quality of life (QoL) among cancer survivors. Methods A total of 388 cancer patients were enrolled to either receive the 21-day MPRRI (n = 129) intervention or a waiting-list comparison (WLC) intervention (n = 259). The intervention group was offered community-based 21-day MPRRI program, combining supportive-expressive group, cognitive-behavioral therapy, and Guolin Qigong. QoL was measured using the European Organization for Research and Treatment Quality of Life Version 3 Questionnaire. Multivariable linear models were used to compare changes in QoL values between the two groups. Results After adjustment for the QoL score and other covariates at baseline, there was no significant difference in global health status (mean = 3.8, 95% CI − 1.3–9.0, P = 0.14) between the two groups after 6 months intervention. While compared with the WLC group, the intervention group showed significant improvements in the QoL score (all P < 0.05); however, there were no clinically relevant changes in subscales including emotional functioning (ES = 0.58), cognitive functioning (ES = 0.53), pain (ES = 0.52), physical functioning (ES = 0.36), and insomnia (ES = 0.30). Conclusions These preliminary results suggest the MPRRI program is both feasible and acceptable intervention for cancer survivors in community settings and is effective in significant improving QoL above.
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Affiliation(s)
- Xuefen Chen
- Key Lab of Public Health Safety of Ministry of Education and Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, No. 130 Dongan RD, Xuhui District, Shanghai, Zip code: 200032, China.,School of Public Health, Shanghai University of Traditional Chinese Medicine, No. 1200 Cailun Rd, Pudong New Area, Shanghai, Zip code: 201203, China
| | - Xiaohuan Gong
- Key Lab of Public Health Safety of Ministry of Education and Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, No. 130 Dongan RD, Xuhui District, Shanghai, Zip code: 200032, China
| | - Changhong Shi
- Key Lab of Public Health Safety of Ministry of Education and Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, No. 130 Dongan RD, Xuhui District, Shanghai, Zip code: 200032, China
| | - Li Sun
- Key Lab of Public Health Safety of Ministry of Education and Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, No. 130 Dongan RD, Xuhui District, Shanghai, Zip code: 200032, China
| | - Zheng Tang
- Key Lab of Public Health Safety of Ministry of Education and Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, No. 130 Dongan RD, Xuhui District, Shanghai, Zip code: 200032, China
| | - Zhengping Yuan
- Shanghai Cancer Rehabilitation Center, No. 164 Zhengning Rd 405 Nong, Shanghai, Zip code: 200050, China
| | - Jiwei Wang
- Key Lab of Public Health Safety of Ministry of Education and Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, No. 130 Dongan RD, Xuhui District, Shanghai, Zip code: 200032, China.
| | - Jinming Yu
- Key Lab of Public Health Safety of Ministry of Education and Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, No. 130 Dongan RD, Xuhui District, Shanghai, Zip code: 200032, China.
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Evans K, Morrell CJ, Spiby H. Systematic review and meta-analysis of non-pharmacological interventions to reduce the symptoms of mild to moderate anxiety in pregnant women. J Adv Nurs 2017; 74:289-309. [PMID: 28921612 DOI: 10.1111/jan.13456] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2017] [Indexed: 11/27/2022]
Abstract
AIM To assess the effectiveness of non-pharmacological interventions for pregnant women with symptoms of mild to moderate anxiety. BACKGROUND Many pregnant women experience mild to moderate symptoms of anxiety and could benefit from additional support. Non-pharmacological interventions have been suggested for use during pregnancy. DESIGN A systematic review of randomized controlled trials. DATA SOURCES Randomized controlled trials published since 1990, identified from electronic databases: Medline; CINAHL; Maternity and Infant Care; PsycINFO; Cochrane Database of Systematic Reviews; CENTRAL; EMBASE; Centre for Reviews and Dissemination; Social Sciences Citation Index; ASSIA; HTA Library; Joanna Briggs Institute Evidence-Based Practice database; Allied and Complementary Medicine. REVIEW METHODS Conducted according to the Centre for Reviews and Dissemination procedure. Papers were screened (N = 5,222), assessed for eligibility (N = 57) and selected for inclusion (N = 25). The Cochrane Collaboration's tool for assessing risk of bias was used. Papers were assessed for clinical and statistical heterogeneity and considered for meta-analysis. Descriptive analysis of the data was conducted. RESULTS Psychological, mind-body, educational and supportive interventions were delivered individually and to groups of pregnant women over single or multiple sessions. The State-Trait Anxiety Inventory was the most commonly used anxiety measure. In 60% of studies there were fewer than 40 participants. Meta-analysis of three studies indicated no observed beneficial effect in the reduction of anxiety. CONCLUSION There was insufficient evidence from which to draw overall conclusions regarding the benefit of interventions. Results were predominantly based on small samples. Many papers provided an inadequate description of methods which prevented a full assessment of methodological quality.
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Affiliation(s)
- Kerry Evans
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - C Jane Morrell
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Helen Spiby
- School of Health Sciences, University of Nottingham, Nottingham, UK.,School of Nursing and Midwifery, University of Queensland, Brisbane, Australia
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A Stress Coping App for Hospitalized Pregnant Women at Risk for Preterm Birth. MCN Am J Matern Child Nurs 2017; 42:257-262. [DOI: 10.1097/nmc.0000000000000355] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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22
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Psychometric Evaluation of the Patient-Reported Outcomes Measurement Information System Fatigue-Short Form Across Diverse Populations. Nurs Res 2017; 65:279-89. [PMID: 27362514 DOI: 10.1097/nnr.0000000000000162] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND The need for reliable, valid tools to measure patient-reported outcomes (PROs) is critical both for research and for evaluating treatment effects in practice. The Patient-Reported Outcomes Measurement Information System Fatigue-Short Form v1.0-Fatigue 7a (PROMIS F-SF) has had limited psychometric evaluation in various populations. OBJECTIVES The aim of the study is to examine psychometric properties of PROMIS F-SF item responses across various populations. METHODS Data from five studies with common data elements were used in this secondary analysis. Samples from patients with fibromyalgia, sickle cell disease, cardiometabolic risk, pregnancy, and healthy controls were used. Reliability was estimated using Cronbach's alpha. Dimensionality was evaluated with confirmatory factor analysis. Concurrent validity was evaluated by examining Pearson's correlations between scores from the PROMIS F-SF, the Multidimensional Fatigue Symptom Inventory-Short Form, and the Brief Fatigue Inventory. Discriminant validity was evaluated by examining Pearson's correlations between scores on the PROMIS F-SF and measures of stress and depressive symptoms. Known groups validity was assessed by comparing PROMIS F-SF scores in the clinical samples to healthy controls. RESULTS Reliability of PROMIS F-SF scores was adequate across samples, ranging from .72 in the pregnancy sample to .88 in healthy controls. Unidimensionality was supported in each sample. Concurrent validity was strong; across the groups, correlations with scores on the Multidimensional Fatigue Symptom Inventory-Short Form and Brief Fatigue Inventory ranged from .60 to .85. Correlations of the PROMIS F-SF with measures of stress and depressive mood were moderate to strong, ranging from .37 to .64. PROMIS F-SF scores were significantly higher in clinical samples compared to healthy controls. DISCUSSION Reliability and validity of the PROMIS F-SF were acceptable. The PROMIS F-SF is a suitable measure of fatigue across the four diverse clinical populations included in the analysis.
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Jones HJ, Sternberg RM, Janson SL, Lee KA. A Qualitative Understanding of Midlife Sources of Stress and Support in African-American Women. JOURNAL OF NATIONAL BLACK NURSES' ASSOCIATION : JNBNA 2016; 27:24-30. [PMID: 29932540 PMCID: PMC6090538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
African-American women suffer from disproportionate adverse health outcomes compared to women of other ethnicities living in the United States. It is suggested in the literature that chron- ic stress can be an antecedent to health disparity. The purpose of this study was to evaluate changes in perceived stress from late pre-menopause to post-menopause and to identify significant life stressors perceived by a cohort of African-American women. Retrospective and current data were used to evaluate perceived stress over time, sources of stress, and resources in a cohort of 15 African-American women. Mixed methodologies were utilized. Perceived stress scores were consistent over time. Six themes were identified in responses about stress: finances, caringforfamily members, relationships, personal health and aging, race and discrimination, and raising children. Understanding the role that unique life stressors play in the lives of African-American women is essential in anticipating the need for assistance and in implementing preventive strategies.
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The Effects of Guided Imagery on Patients Being Weaned from Mechanical Ventilation. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:802865. [PMID: 26640501 PMCID: PMC4657064 DOI: 10.1155/2015/802865] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 10/19/2015] [Accepted: 10/21/2015] [Indexed: 11/17/2022]
Abstract
The study purpose was to assess the effects of guided imagery on sedation levels, sedative and analgesic volume consumption, and physiological responses of patients being weaned from mechanical ventilation. Forty-two patients were selected from two community acute care hospitals. One hospital served as the comparison group and provided routine care (no intervention) while the other hospital provided the guided imagery intervention. The intervention included two sessions, each lasting 60 minutes, offered during morning weaning trials from mechanical ventilation. Measurements were recorded in groups at baseline and 30- and 60-minute intervals and included vital signs and Richmond Agitation-Sedation Scale (RASS) score. Sedative and analgesic medication volume consumption were recorded 24 hours prior to and after the intervention. The guided imagery group had significantly improved RASS scores and reduced sedative and analgesic volume consumption. During the second session, oxygen saturation levels significantly improved compared to the comparison group. Guided imagery group had 4.88 less days requiring mechanical ventilation and 1.4 reduction in hospital length of stay compared to the comparison group. Guided imagery may be complementary and alternative medicine (CAM) intervention to provide during mechanical ventilation weaning trials.
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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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The Effects of Guided Imagery on Heart Rate Variability in Simulated Spaceflight Emergency Tasks Performers. BIOMED RESEARCH INTERNATIONAL 2015; 2015:687020. [PMID: 26137491 PMCID: PMC4475552 DOI: 10.1155/2015/687020] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Revised: 01/16/2015] [Accepted: 02/09/2015] [Indexed: 01/17/2023]
Abstract
Objectives. The present study aimed to investigate the effects of guided imagery training on heart rate variability in individuals while performing spaceflight emergency tasks. Materials and Methods. Twenty-one student subjects were recruited for the experiment and randomly divided into two groups: imagery group (n = 11) and control group (n = 10). The imagery group received instructor-guided imagery (session 1) and self-guided imagery training (session 2) consecutively, while the control group only received conventional training. Electrocardiograms of the subjects were recorded during their performance of nine spaceflight emergency tasks after imagery training. Results. In both of the sessions, the root mean square of successive differences (RMSSD), the standard deviation of all normal NN (SDNN), the proportion of NN50 divided by the total number of NNs (PNN50), the very low frequency (VLF), the low frequency (LF), the high frequency (HF), and the total power (TP) in the imagery group were significantly higher than those in the control group. Moreover, LF/HF of the subjects after instructor-guided imagery training was lower than that after self-guided imagery training. Conclusions. Guided imagery was an effective regulator for HRV indices and could be a potential stress countermeasure in performing spaceflight tasks.
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