Comparison of Hypnotherapy and Standard Medical Treatment Alone on Quality of Life in Patients with Irritable Bowel Syndrome: A Randomized Control Trial

Long-Term Follow-up of Individual Therapist Delivered and Standardized Hypnotherapy Recordings in Pediatric Irritable Bowel Syndrome or Functional Abdominal Pain

OBJECTIVES

We previously showed that standardized home-based gut-directed hypnosis exercises with compact disc (CD) is non-inferior to individual hypnotherapy (iHT) by a therapist in the treatment of children with irritable bowel syndrome (IBS) and functional abdominal pain (syndrome) (FAP(S)). Aim of this follow-up study was to investigate the long-term effects of standardized-hypnosis-recordings at home in comparison to iHT.

METHODS

All participants from our previous randomized controlled trial were invited to complete: 1) an online standardized abdominal pain dairy, on which pain frequency and intensity were scored, and 2) an online questionnaire including adequate relief (AR), anxiety/depression scores, somatization, quality of life (QOL), pain beliefs, school and/or work absenteeism and health care utilization.

RESULTS

227 out of 250 (91%) participants completed this study. After a median duration of 6 years follow-up (5.8-6.2), 80.0% in the CD group vs 86.6% in the iHT group reported AR of their abdominal complaints (P=.22). Compared to the 1-year follow-up, AR percentages were stable. Treatment success was seen in 67.6% in the CD group vs 71.3% in the iHT group (P=.66). Anxiety and depression scores, somatization, pain beliefs, health care utilization and school/work absenteeism also improved significantly in both study groups compared with baseline. No differences were found in QOL-scores.

CONCLUSIONS

Both home-based treatment with standardized-hypnosis-recordings and iHT given by a therapist show persisting positive results in more than 80% of children with IBS and FAP(S) after 6 years of follow-up. These results support the rationale for implementation of this easy-to-use, widely available and cost-effective home-treatment in daily practice.

systematic review on role of hypnotherapeutic intervention in promoting positive psychological health

In this world of fast moving day to day activities, it is of utmost importance that every individual is aware of their personal well- being and take steps towards improving these over the course of time (Al-Asmi et al., 2015; Amato et al., 2001). The state of well – being can be described as understanding the quality of life led by various individuals (Statham & Chase, 2010). The concept of well- being in humans is broadly classified into two aspects - the first one is associated with having life satisfaction and a positive effect in one’s life.the study here is only focused towards the use of hypnotherapeutic interventions in the process of promoting a positive psychological heath scenario all across. The study undertakes a systematic review approach with 51 articles and aims to put forward a summarised version of the literature in the aspect of  hypnotherapeutic interventions.The result of the study identifies a total of three themes from the systematic literature review conducted. It is found that the three identified themes have been put forward by researchers as the most effective impact of hypnotherapeutic interventions. 

Effect of Hypnotism on the Severity of Gastrointestinal Symptoms and Quality of Life in Individuals With Irritable Bowel Syndrome

The current study aimed to determine the effects of hypnotism on the severity of gastrointestinal symptoms and quality of life in individuals with irritable bowel syndrome (IBS). This trial study was conducted on 100 people with IBS in Shiraz, Iran. Hypnotism of participants was performed in 1-hour sessions for the intervention group at Weeks 4 and 6. A demographic characteristic questionnaire, Gastrointestinal Symptom Rating Scale, and IBS Quality of Life Index were used for data collection. The severity of gastrointestinal symptoms of participants in the intervention group significantly improved at 6 and 15 weeks after hypnotherapy. These individuals also had a significantly better quality of life after 15 weeks of hypnotherapy. Hypnotherapy may be beneficial in reducing gastrointestinal symptoms and improving quality of life in individuals with IBS. Combining this method with medicinal treatments could be effective for patients and health systems. [Journal of Psychosocial Nursing and Mental Health Services, xx(x), xx-xx.].

Comparing the Effects of Massage Therapy and Aromatherapy on Knee Pain, Morning Stiffness, Daily Life Function, and Quality of Life in Patients with Knee Osteoarthritis

BACKGROUND

Knee osteoarthritis is the most common articular disease, and non-medical treatment of this disease has attracted the attention of researchers. The purpose of this study was to compare the effects of aromatherapy and massage therapy on knee pain, morning stiffness, daily life function, and quality of life in patients with knee osteoarthritis.

METHODS

This is a clinical trial. In this study, 93 patients referred to the Imam Ali Hospital (Physical Therapy Clinic) who entered the study were randomly divided into three groups including massage therapy (n = 31), aromatherapy (n = 31), and the control (n = 31). The data gathering tools were a demographic characteristics questionnaire and the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire. The questionnaire was completed before intervention and at the 5th and 10th sessions after intervention in all three groups. Data were analyzed by SPSS software version 20, and Chi-square, Fisher's exact test, repeated measures test, one-way ANOVA test, and Tukey's post hoc test were used for analysis.

RESULTS

The study shows that mean score subscale Symptoms and dryness in the 5th session and 10th session of intervention in the aromatherapy group is significantly higher than in the control group (p < 0.05). The massage therapy group had the highest pain score at the beginning of the intervention, but at the end of the 10th session of intervention had the least pain score. Mean score subscale Performance of daily life in the 5th session and 10th session of intervention in the aromatherapy group is significantly higher than in the control group (p < 0.05). Mean score in the subscale Performance, exercise, and recreational activities significantly differs between the aroma therapy and massage therapy groups compared with the control group in all times of interventions (p < 0.05), and in the mean score in the subscale Quality of life, there is no significant difference between the groups in all times of interventions (p > 0.05).

CONCLUSION

The use of both massage therapy and aromatherapy is recommended for patients with knee osteoarthritis. Interventions should be prolonged for at least 6 months in patients so their effects appear on the patient.

The Prevalence of Infectious Keratitis after Keratorefractive Surgery: A Systematic Review and Meta-Analysis Study

BACKGROUND

The keratorefractive surgeries (KRS) are one of the most common ocular surgeries. One of the dangerous complications of these surgeries is infectious keratitis (IK), which is the second cause of blindness after cataract surgery. The purpose of this study was to estimate the prevalence of IK after KRS in different parts of the world.

METHODS

In order to obtain relevant studies, all national and international databases including IranMedex, SID, Magiran, IranDoc, Medlib, ScienceDirect, PubMed, Scopus, Cochrane, Embase, Web of Science, and Google Scholar were searched using standard keywords.

RESULTS

IK prevalence after KRS was 0.000496% (0.000145% for the left eye and 0.000149% for the right eye). IK prevalence after KRS in the United States, Europe, and Asia was 0.000667%, 0.000473%, and 0.000045%, respectively, in all of which the common microorganisms were Staphylococci. Meta-regression showed no significant association between IK after KRS and either sample size or publication year of the studies. IK prevalence after KRS in the right eye was more than that in the left one. Also, the probability of IK incidence after LASIK surgery was more than PRK and LASEK. In the evaluation of continents, IK after KRS in the United States was more frequent compared with Europe and Asia.

CONCLUSIONS

This study provided data as to the overall prevalence of IK following KRS and its variations according to the types of eye, surgery, pathogenic microorganism, and geographical location.

Systematic Review and Meta-analysis of Quality of Work Life in Iran (2011-2017)

BACKGROUND

Quality of work life (QWL) is considered as a universal concept in human resource management and organizational development, and its promotion is the key to the success of organizations' management. Therefore, the present study aimed to evaluate the QWL in Iran through systematic review and meta-analysis.

METHODS

In this study, all articles related to the QWL in Iran during the years 2011-2017 were systemically reviewed by searching national and international databases such as Science Direct, PubMed, Scopus, Web of Science, Springer, SID, Magiran, Barakat Knowledge Network System, Medlib, and the Google Scholar search engine using valid keywords. The results of the studies were combined using the random effects model. The heterogeneity of studies was studied using the I2 index. Data analysis was done using STATA ver 11.

RESULTS

The mean QWL score of 15,323 samples were 60.13, 36.80, 76.19, 58.90, 68.78, 50.69, 32.24, 8.01, 70.63, 39.70, and 44.41 based on Walton, Casio, Sirgy, Mirsepasi, SF-36, Ghasem zadeh, Dehghan, Dargahi, NIOSH, Venlar, Quality of nursing work life questionnaires, respectively. Meta-regression showed that the QWL of employees had no significant relationship with the sample size and years of research.

CONCLUSIONS

The mean score of QWL in Iranian employees was 56.90, with the highest and the lowest score for the questionnaire.

Comparing the Effect of Intranasal Lidocaine 4% with Peppermint Essential Oil Drop 1.5% on Migraine Attacks: A Double-Blind Clinical Trial

Background:

Prevalence of migraine, as a chronic neurovascular disorder, was approximately 10.3 and 23.1% among men and women, respectively, mostly in people younger than 40 years old. Migraine is prevalent in different geographic areas worldwide. The present study was designed to compare the impact of intranasal lidocaine 4% and peppermint essential oil drop 1.5% on migraine attacks.

Methods:

In this double-blind, parallel, randomized controlled trial, 120 adult patients with a diagnosis of migraine based on the International Headache Society criteria were treated with intranasal lidocaine drop 4% or peppermint essential oil drop 1.5% or placebo. Patients expressed their symptoms 5 and 15 min after dripping, and if they still had a headache after 15 min, they were given the second dose. Patients with a second dose of medication, 15 min later recorded their headache rate. All patients recorded their symptoms after 30 min. Symptoms of the patients were followed by a researcher through the phone and in-person after 2 months. Then, the questionnaires were filled.

Results:

In the present study, there was a significant difference among groups in headache intensity after treatment (P < 0.001). In 40% of the patients in the peppermint oil and lidocaine groups, the intensity of headache decreased. In the placebo group, fewer patients responded highly to the treatment, whereas 41.5% of patients in the lidocaine group and 42.1% of patients in the peppermint oil group responded to the treatment considerably.

Conclusions:

Concerning the findings of the present study, nasal application of peppermint oil caused considerable reduction in the intensity and frequency of headache and relieved majority of patients' pain similar to lidocaine. On the basis of findings of this study, it can be concluded that nasal menthol, such as lidocaine, can be used to relieve migraine headaches.

Estimation of Mean Intelligence Quotient with Wechsler Scale in Iran: Systematic Review and Meta-Analysis

The low intelligence quotient (IQ) level is one of the most common and important medical, social, and familial problems in all countries. The current study aimed to estimate mean IQ with the Wechsler scale in Iran by performing a systematic review and meta-analysis. In the current meta-analysis, all articles related to IQ conducted in Iran using the Wechsler scale were deeply searched by reviewing citation databases including Science Direct, PubMed, Scopus, Web of Science, Springer, SID, Magiran, Iranmedex, Medlib, and Google Scholar motor search and using valid keywords without time limits. Due to heterogeneity between studies, a random effects model was used to combine the results of studies. To investigate the heterogeneity of the studies, the I2 index was used. All statistical analyses were performed using STATA software version 11.1. The number of participants in the 51 studies was 5352. The mean total IQ score in Iran was estimated 97.12 (95% confidence interval [CI]: 88.71-105.52), the practical intelligence was 92.84 (95% CI: 79.14-106.55), and the verbal intelligence was 94.50 (95% CI: 83.90-105.10). The total IQ score in the northern, southern, central, eastern, and western regions of Iran was 97.08, 108.90, 92.31, 101.76, and 96.45, respectively. The mean IQ score in Iran in subjects under 20 years of age is 97.73 and in subjects over 20 years of age is 105.61. There is also no significant relationship between the mean total IQ in Iran and two parameters of the year of research and number of research samples. For prevention of decrease IQ and given that proper nutrition and breastfeeding directly contribute to increase IQ, nutrition should be provided free of charge in poorer areas during pregnancy until baby born. Moreover, the media should provide adequate education for breastfeeding and nutrition, because IQ affects people's academic, occupational, personal, and social performance, and also prevents elite immigration with suitable planning and provides conditions for elites to return to the country.

Nesfatin-1 in the dorsal raphe nucleus influences visceral sensitivity via 5-HT neurons in male maternally separated rats

Nesfatin-1, a satiety molecule processed from nucleobindin2 (NUCB2), is implicated in visceral hypersensitivity in rats and colocalized with 5-hydroxytryptamine (5-HT) in the dorsal raphe nucleus (DRN). Maternal separation (MS) in rats contributes to visceral hypersensitivity via elevated expression of 5-HT in the DRN. Intracerebroventricular injection of nesfatin-1 activates DRN 5-HT neurons. In this study, A model of visceral hypersensitivity was developed by subjecting rats to MS. Colorectal distension was used to detect visceral sensitivity, which was evaluated by abdominal withdrawal reflex (AWR) scores and electromyogram (EMG) magnitude. MS rats exhibited higher AWR scores and EMG magnitude compared with controls. The numbers of nesfatin-1- and tryptophan hydroxylase (TPH, the rate-limiting enzyme for 5-HT synthesis)-positive cells in the DRN were significantly elevated accordingly. Visceral hypersensitivity was significantly alleviated in MS rats treated with intra-DRN administration of anti-nesfatin-1/NUCB2, accompanied by decreased expression of 5-HT and TPH in the DRN, compared with the vehicle-treated group. In contrast, intra-DRN administration of nesfatin-1 into normal adult rats induced visceral hypersensitivity, which correlated with elevated expression of 5-HT and TPH in the DRN. In conclusion, Nesfatin-1 has critical effects on visceral hypersensitivity; the underlying mechanisms might be related to the activation of DRN 5-HT neurons.

Self-Perception of Iranian Patients during their life with Irritable Bowel Syndrome: A Qualitative Study

Background

Irritable bowel syndrome (IBS), as a chronic digestive disorder, impacts extensively on the quality of life, emotional well-being and self-identity. Chronic illness disrupts taken-for-granted notions about self. No qualitative study was found regarding patients’ experience of life with irritable bowel syndrome (IBS) in Iran.

Objective

To explore the self-perception of lived experience of IBS patients.

Methods

A qualitative study with hermeneutic phenomenological approach was conducted on 12 IBS patients who had been referred to three central clinics (2 governmental and 1 private) affiliated to Shiraz University of Medical Sciences. The data were collected through in-depth semi-structured interviews from July 2015 to September 2016 by purposeful sampling. Thematic analysis was carried out using Van Manen’s six-step methodological framework as a guide. In addition, MAXQDA software was used for data management.

Results

In this study, two main themes “the threatened self” and “deep self-knowledge”, emerged during the life of patients with IBS, indicating the meaning of self-perception of such patients. The theme of “the threatened self” consisted of two subthemes of “fear from stigmatization” and “bad sense of self”. The subthemes of “body knowledge”, “self-acceptance” and “personal growth” were related to deep self-knowledge.

Conclusion

The results of the present study could be applied in designing and implementation effective and holistic care of IBS patients.

The Effectiveness of Mindfulness-based Cognitive Therapy on Psychological Symptoms and Quality of Life in Systemic Lupus Erythematosus Patients: A Randomized Controlled Trial

OBJECTIVES

This study was conducted to determine the efficacy of mindfulness-based cognitive therapy (MBCT) on psychological symptoms and quality of life (QoL) in patients with systemic lupus erythematosus (SLE).

METHODS

We conducted a randomized single-blind clinical trial in patients with SLE referred from the Imam Ali Clinic in Shahrekord, southwest Iran. The patients (46 in total in two groups of 23 each) were randomly assigned into the experimental and control groups. Both groups underwent routine medical care, and the experimental group underwent eight group sessions of MBCT in addition to routine care. The patient^,s QoL was assessed using the General Health Questionnaire-28 and 36-Item Short Form Health Survey before, after, and six months after intervention (follow-up).

RESULTS

A significant difference was seen in psychological symptoms and QoL between MBCT and control groups immediately after the intervention and at follow-up (p ≤ 0.050). However, the difference was not significant for the physical components of QoL (p ≥ 0.050).

CONCLUSIONS

MBCT contributed to decreased psychological symptoms and improved QoL in patients with SLE with a stable effect on psychological symptoms and psychological components of QoL, but an unstable effect on physical components.

Psychological Interventions for Irritable Bowel Syndrome and Inflammatory Bowel Diseases

Psychological interventions have been designed and implemented effectively in a wide range of medical conditions, including Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Diseases (IBD). The psychological treatments for IBS and IBD with the strongest evidence base include: cognitive behavioral therapy, hypnosis, and mindfulness-based therapies. The evidence for each of these therapies is reviewed here for both IBS and IBD. In general, there is a stronger and larger evidence base to support the use of psychological interventions in IBS compared with IBD. This is likely due to the high level of psychiatric comorbidity associated with IBS and the involvement of the stress-response in symptom presentation of IBS. Further research in psychosocial interventions for IBD is necessary. Finally, the importance of conceptualizing both IBS and IBD in a biopsychosocial model is discussed and several resources for accessing Clinical Health Psychology materials and referrals are provided.

A Comparison of the Effects of Pilates and McKenzie Training on Pain and General Health in Men with Chronic Low Back Pain: A Randomized Trial

Background:

Today, chronic low back pain is one of the special challenges in healthcare. There is no unique approach to treat chronic low back pain. A variety of methods are used for the treatment of low back pain, but the effects of these methods have not yet been investigated adequately.

Aim:

The aim of this study was to compare the effects of Pilates and McKenzie training on pain and general health of men with chronic low back pain.

Materials and Methods:

Thirty-six patients with chronic low back pain were chosen voluntarily and assigned to three groups of 12 each: McKenzie group, Pilates group, and control group. The Pilates group participated in 1-h exercise sessions, three sessions a week for 6 weeks. McKenzie group performed workouts 1 h a day for 20 days. The control group underwent no treatment. The general health of all participants was measured by the General Health Questionnaire 28 and pain by the McGill Pain Questionnaire.

Results:

After therapeutic exercises, there was no significant difference between Pilates and McKenzie groups in pain relief (P = 0.327). Neither of the two methods was superior over the other for pain relief. However, there was a significant difference in general health indexes between Pilates and McKenzie groups.

Conclusion:

Pilates and McKenzie training reduced pain in patients with chronic low back pain, but the Pilates training was more effective to improve general health.

Effect of Sleep Hygiene Education on Sleep Quality in Hemodialysis Patients

INTRODUCTION

Sleep is referred a regular, recurring and easily revocable state of organism which is characterized by relative immobility and significant increase in response threshold to environmental stimuli. Sleep disorders are common among haemodialysis patients.

AIM

The aim of this study was to investigate the effect of sleep hygiene education on sleep quality in haemodialysis patients.

MATERIALS AND METHODS

This study is a randomized controlled clinical trial. The participants of this study were 60 haemodialysis patients admitted to the Dialysis Center of Shahid Ayatollah Madani Hospital of Khoy, affiliated with the Urmia University of Medical Sciences. Sampling was done randomly and the partcipants were randomly divided into intervention group (30 patients) and control group (30 patients). Sleep quality of participants was measured before and after the intervention by Pittsburgh Sleep Quality Index (PSQI). Training process for sleep hygiene behaviours was presented to the participants face-to-face. The data were analysed using SPSS 16.

RESULTS

A significant difference in the mean (standard deviation) score for PSQI (p<0.001) was observed before and after intervention in the intervention group, while in the control group, the difference was not significant (p=0.704), In addition, a significant difference was observed in the mean (standard deviation) score for PSQI between the two, intervention and control groups after the educational intervention (p=0.034).

CONCLUSION

Sleep hygiene education, alongside other appro-aches, is a low-cost, accessible and practical method which can be implemented within a short period of time.