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Bahari G, Kerari A. Evaluating the Effectiveness of a Self-Management Program on Patients Living with Chronic Diseases. Risk Manag Healthc Policy 2024; 17:487-496. [PMID: 38449511 PMCID: PMC10916514 DOI: 10.2147/rmhp.s451692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 02/21/2024] [Indexed: 03/08/2024] Open
Abstract
Background Chronic diseases are a major public health concern globally, and the position in Saudi Arabia is no exception. The Chronic Disease Self-Management Program (CDSMP) is a widely used intervention process to address care of chronic conditions. However, its effectiveness in a Saudi context has not been extensively studied. Therefore, this study aimed at evaluating the post-intervention outcomes of the CDSMP in Saudi Arabia. Materials and Methods The study utilized a qualitative design on patients with chronic conditions. Data were collected through two focus group sessions with 15 participants who had completed the CDSMP. A thematic analysis technique was used for data analysis. Results Three key themes emerged from analysis of the qualitative data obtained through the focus groups: the perceived benefits from participation in the CDSMP workshop; the impact of the CDSMP workshop on improving health status and quality of life; and, the cultural acceptability of the CDSMP. The study also found that the CDSMP was effective in improving participants' self-management skills and quality of life. Additional benefits included increased motivation for behavioral change, enhanced confidence regarding self-care of chronic conditions, improved communication with healthcare providers, and better coping strategies. Conclusion This study provides valuable insights into the effectiveness of the CDSMP in addressing chronic conditions in Saudi Arabia. The program's emphasis on self-management skills and peer support aligns with the cultural values of Saudi Arabia. However, applying the CDSMP across various chronic conditions should be addressed in future interventions.
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Affiliation(s)
- Ghareeb Bahari
- Nursing Administration and Education Department, College of Nursing, King Saud University, Riyadh, 11421, Saudi Arabia
| | - Ali Kerari
- Nursing Administration and Education Department, College of Nursing, King Saud University, Riyadh, 11421, Saudi Arabia
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Yap AU, Wee KK, Loh JY, Marpaung C, Natu VP. Temporomandibular disorder pain in older adolescents-young adults: Interrelationship with somatic burden, mental ill-being, and well-being. Cranio 2024:1-11. [PMID: 38415618 DOI: 10.1080/08869634.2024.2322595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
OBJECTIVES The associations of Temporomandibular disorder (TMD) pain with somatic symptoms, mental ill-being/distress, and well-being were explored, along with the mental correlates of TMD (TS) and somatic symptom (SS) burden in older adolescents-young adults. METHODS TMD/somatic symptoms were appraised with the five quintessential symptoms (5Ts) of the DC/TMD/Somatic Symptom Scale-8, whereas mental distress/well-being was assessed with the Depression, Anxiety, Stress Scales-21/Scales of Psychological Well-being-18. Data were examined using Chi-square/non-parametric tests and multivariate analyses (α = .05). RESULTS Among the 366 participants, 51.4%, 28.1%, 6.8%, and 13.7% had no TMD (NT), TMD pain (TP), TMD dysfunction (TD), and combined TMD (CT) respectively. Though mental distress varied substantially (CT, TP>NT, TD), no significant differences in well-being were discerned. SS burden, but not TS burden, was moderately correlated to distress. CONCLUSIONS The prospect of TMD pain was increased by being female, depressed, and anxious but reduced by "positive relations with others" and "self-acceptance".
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Affiliation(s)
- Adrian Ujin Yap
- Department of Dentistry, Ng Teng Fong General Hospital and Faculty of Dentistry, National University Health System, Singapore
- National Dental Research Institute Singapore, National Dental Center Singapore and Duke-NUS Medical School, Singapore Health Services, Singapore
| | - Kai Kee Wee
- School of Health and Social Sciences, Nanyang Polytechnic, Singapore
| | - Jia Yu Loh
- School of Health and Social Sciences, Nanyang Polytechnic, Singapore
| | - Carolina Marpaung
- Department of Prosthodontics, Faculty of Dentistry, Trisakti University, Jakarta, Indonesia
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Xu L, Shi J, Li C. Addressing psychosomatic symptom distress with mindfulness-based cognitive therapy in somatic symptom disorder: mediating effects of self-compassion and alexithymia. Front Psychiatry 2024; 15:1289872. [PMID: 38384594 PMCID: PMC10879322 DOI: 10.3389/fpsyt.2024.1289872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 01/02/2024] [Indexed: 02/23/2024] Open
Abstract
Objective This study explored the association between self-compassion, alexithymia, and psychosomatic symptom distress in a clinical sample of somatic symptom disorder (SSD) patients participating in a mindfulness-based cognitive therapy (MBCT) program. Methods One hundred sixteen SSD patients who had participated in an MBCT program and completed ≥4 intervention sessions were included in a retrospective study (76.7% women, mean age = 40.0, SD = 9.5). Psychometric measures of psychosomatic symptom distress [Brief Symptom Inventory-18 Global Severity Index (BSI-GSI)], self-compassion [Self-Compassion Scale (SCS)], and alexithymia [Toronto Alexithymia Scale (TAS)] were collected upon admission to the MBCT program and at 6-month follow-up following treatment inclusion. Results Serial mediation analysis (MBCT→ΔSCS→ΔTAS→ΔBSI-GSI) suggested that changes in both self-compassion and alexithymia had significant indirect effects on improvement in psychosomatic distress [ΔSCS β = -1.810, 95% bootstrap CI (-2.488, -1.160); ΔTAS β = -1.615, bootstrap 95% CI (-2.413, -0.896); ΔSCS→ΔTAS β = -0.621, bootstrap CI (-1.032, -0.315)]. Furthermore, a post-hoc analysis with a reverse sequence (MBCT→ΔTAS→ΔSCS→ΔBSI-GSI) revealed that reduction in alexithymia improved psychosomatic distress and that an increase in self-compassion was a subsequent outcome of alleviation of alexithymia [ΔTAS β = -2.235, bootstrap 95% CI (-3.305, -1.270); ΔSCS β = 0.013, 95% bootstrap CI (-0.600, 0.682); ΔTAS→ΔSCS β = -1.823, bootstrap CI (-2.770, -1.047)]. Conclusion Both alleviation of alexithymia and improvement in self-compassion play a mediating role in the reduction of psychosomatic distress in SSD patients following an MBCT program. Improvement in self-compassion might be a subsequent outcome of MBCT-related alleviation of alexithymia.
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Affiliation(s)
- Lianrong Xu
- Department of Pain Management, Jinxiang Hospital Affiliated to Jining Medical University, Jining, China
| | - Jihong Shi
- Department of Consultation Psychology, Jining First People's Hospital, Jining, China
| | - Chengwen Li
- Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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Brown CK, Vazquez J, Metz SM, McCown D. Effects of an 8-Week Mindfulness Course in People With Voice Disorders. J Voice 2023:S0892-1997(23)00353-3. [PMID: 37977967 DOI: 10.1016/j.jvoice.2023.10.031] [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: 09/12/2023] [Revised: 10/25/2023] [Accepted: 10/26/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVES Nearly every modern textbook on the etiology and treatment of voice disorders (VD) recommends stress reduction for VD patients. The benefits of mindfulness for stress reduction are well documented, but published literature on mindfulness and VD is sparse. Our objective was to determine whether an 8-week mindfulness course could increase mindfulness and lower stress in people with VD, leading to a decrease in vocal handicap. STUDY DESIGN Mixed methods study. METHODS Participants: 69 individuals with VD: 39 were mindfulness course participants (MCP), 30 were in a waitlist control group (WCG). Exclusionary criteria: patients in voice therapy. Before and after the 8-week timeframe, participants took the Mindful Attention and Awareness Scale (MAAS), Perceived Stress Scale-10 (PSS-10), Voice Handicap Index (VHI), and-for singers (n = 36)-the Singing Voice Handicap Index (SVHI). Follow-up interviews were conducted with select participants. RESULTS In the MCP, each of the outcomes significantly changed in the direction hypothesized, resulting in increased MAAS (P = 0.000) and decreased PSS-10 (P = 0.007), VHI (P = 0.000), and SVHI (P = 0.021, n = 22) scores. Using a 2 × 2 Repeated Measures ANOVA, two outcomes were statistically different for the MCP from pre to postcourse-MAAS increased (P = 0.006, ES = 0.107) and VHI decreased (P = 0.034, ES = 0.065)-in comparison to no change in the WCG. Follow-up interviews revealed increased acceptance of the VD; reduced stress, physical tension, and pain/discomfort; increased somatic (or interoceptive) awareness; community with other VD patients; and positive speaking and singing voice changes. CONCLUSIONS An 8-week mindfulness course shows promise for reducing stress in people with VD, lowering voice handicap, and improving quality of life. Future research should evaluate mindfulness in patients with specific voice disorders; patients with higher and lower VHI scores; singers; and patients who experience throat pain. Mindfulness should also be evaluated within a standard voice therapy protocol.
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Affiliation(s)
- Catherine Kay Brown
- West Chester University of Pennsylvania, Department of Public Health Sciences, Center for Contemplative Studies, West Chester, Pennsylvania; Immaculata University, Department of Music, Immaculata, Pennsylvania.
| | - Julinette Vazquez
- West Chester University of Pennsylvania, Department of Public Health Sciences, West Chester, Pennsylvania
| | - Stacie M Metz
- West Chester University of Pennsylvania, Department of Public Health Sciences, West Chester, Pennsylvania
| | - Donald McCown
- West Chester University of Pennsylvania, Department of Public Health Sciences, Center for Contemplative Studies, West Chester, Pennsylvania
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Maas genannt Bermpohl F, Hülsmann L, Martin A. Efficacy of mindfulness- and acceptance-based cognitive-behavioral therapies for bodily distress in adults: a meta-analysis. Front Psychiatry 2023; 14:1160908. [PMID: 37151971 PMCID: PMC10157071 DOI: 10.3389/fpsyt.2023.1160908] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 04/04/2023] [Indexed: 05/09/2023] Open
Abstract
Objective Bodily distress, i.e., somatoform disorders and associated functional somatic syndromes, is highly prevalent, often persistent and highly disabling. It has been proposed that "third wave" therapies may be beneficial variants of cognitive behavioral treatments. However, evidence on their efficacy is scarce. This meta-analysis examines the efficacy of "third wave" psychotherapies (mindfulness-based cognitive therapy [MBCT], mindfulness-based stress reduction [MBSR], and acceptance and commitment therapy [ACT]) in adults with bodily distress. Method We included randomized controlled trials (RCTs) treating adults with bodily distress using MBCT, MBSR, and ACT compared to inactive and non-specific control groups. A random effects model was used. The primary outcome was somatic symptom severity. Secondary outcomes were degrees of depression and of anxiety, health anxiety, perceived health status, mindfulness, psychological inflexibility, and pain acceptance. Results Sixteen RCTs with 1,288 participants were included in the analysis (k = 4 MBCT, k = 7 MBSR, k = 5 ACT; k = 7 fibromyalgia, k = 5 irritable bowel syndrome, k = 1 chronic fatigue syndrome, k = 2 bodily distress, k = 1 medically unexplained symptoms). However, not all studies provided data for each of the relevant outcomes. The analyses revealed that "third wave" therapies were more effective than control conditions in reducing somatic symptom severity (k = 15, n = 1,100, g = -0.51, 95%CI -0.69; -0.32). Heterogeneity was moderate (I 2 = 52.8%, 95%CI 15.1 to 73.8). Effects for secondary outcomes were small to moderate with varying degrees of heterogeneity. We did not find differences between the different therapy approaches (mindfulness- vs. acceptance-based therapies); neither therapy dosis (i.e., total duration of therapy sessions) nor number of sessions were significant moderators of efficacy. Conclusions The therapies addressing mindfulness and acceptance proved to be more effective than control conditions. Hence, they are promising treatment approaches for bodily distress. However, there is still need for research on which patient groups may benefit from these psychological approaches. Systematic review registration https://osf.io/g7hby, identifier: 10.17605/OSF.IO/4RZGC.
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Micheli N, Porcelli P, Barrault-Couchouron M, Dantzer C. Does the practice of mindfulness reduce somatic symptoms and COVID-19-related anxiety? A community-based survey. Front Psychol 2022; 13:996559. [PMID: 36571039 PMCID: PMC9784913 DOI: 10.3389/fpsyg.2022.996559] [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: 07/17/2022] [Accepted: 11/21/2022] [Indexed: 12/13/2022] Open
Abstract
Objective Since the beginning of COVID-19 pandemic, several studies have shown an increase of psychological distress in the general population. Previous research demonstrated that high levels of anxiety are associated with reporting more somatic symptoms. The ability to adaptively regulate emotions is essential to deal with stressful situations, and it is one of the main components of mindfulness practice. The aim of the present study was to document the effect of mindfulness practice on somatic symptoms and psychological distress in the context of COVID-19 pandemic. Methods The study has a descriptive cross-sectional design. During the second wave of COVID-19 pandemic, between November 2020 and January 2021 participants living in France responded to an online survey on the impact of COVID-19 on psychological distress and physical health. The questionnaire included the assessment of COVID-19-related anxiety, mindfulness practice and experience, dispositional mindfulness, somatization, depression, generalized anxiety, and emotion regulation. Results A total of 569 people (mean age = 39.8 years, 90% women) were included in the study. COVID-19 related anxiety was associated with higher levels of somatic symptoms, generalized anxiety, and depression. About half of the sample (n = 318, 56%) reported moderate to severe somatic symptoms that were associated with higher levels of depression and anxiety, lower levels of dispositional mindfulness and to the use of maladaptive emotion regulation strategies. Overall, 164 subjects (28.8%) reported practicing meditation. No differences were found in dispositional mindfulness (MAAS score) between beginners and advanced practitioners, regardless of the type, years, frequency, and length of practice. Participants with less experience in mindfulness practice reported a significant higher number of somatic symptoms than non-practitioners and a higher use of rumination. Moreover, mindfulness experience was associated with the use of more adaptive emotion regulation strategies. Conclusion Mindfulness meditation has been promoted as a practice enhancing well-being and helping to cope with the psychological impact of stressful events. However, in a distressing situation as COVID-19 pandemic, a limited experience in mindfulness practices might result in the development or endurance of somatic symptoms. Adequate training and a focus on mindful acceptance, may contribute to enhance the effectiveness of mindfulness practice.
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Affiliation(s)
- Noemi Micheli
- Univertité de Bordeaux, LabPsy UR 4139, Bordeaux, France,*Correspondence: Noemi Micheli,
| | - Piero Porcelli
- Department of Psychological, Health and Territorial Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | | | - Cécile Dantzer
- Univertité de Bordeaux, LabPsy UR 4139, Bordeaux, France
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Sugaya N, Shirotsuki K, Nakao M. Cognitive behavioral treatment for irritable bowel syndrome: a recent literature review. Biopsychosoc Med 2021; 15:23. [PMID: 34838129 PMCID: PMC8626893 DOI: 10.1186/s13030-021-00226-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 11/15/2021] [Indexed: 12/31/2022] Open
Abstract
Irritable bowel syndrome (IBS) is a gastrointestinal psychosomatic disorder that often develops and worsens with stress. Hence, it is important to treat it from both, its physical and mental aspects. We reviewed recent research on cognitive-behavioral therapy (CBT)—one of the most widely studied psychological treatments for IBS—since it focuses on addressing the cognitions and behaviors associated with IBS symptoms, and combines diverse content, such as cognitive techniques, exposure, stress management, and mindfulness, whose effects have been widely studied. Research on CBT for IBS varies not only in terms of content of the interventions, but also in terms of implementation (individual or group, face-to-face or online). Internet-delivered CBT has recently shown the possibility of providing more accessible and cost-effective psychological intervention to IBS patients in formats, other than face-to-face. In recent years, many standardized scales that allow for IBS-specific psychological assessments have been used in clinical studies of CBT for IBS. Tools that competently deliver effective interventions and properly measure their effectiveness are expected to spread to many people suffering from IBS.
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Affiliation(s)
- Nagisa Sugaya
- Unit of Public Health and Preventive Medicine, School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama City, 236-0004, Japan.
| | - Kentaro Shirotsuki
- Graduate School of Human and Social Sciences, Musashino University, Tokyo, Japan
| | - Mutsuhiro Nakao
- Department of Psychosomatic Medicine, School of Medicine, International University of Health and Welfare, Chiba, Japan
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