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Kariyawasam L, Ononaiye M, Irons C, Kirby SE. Compassion-based interventions in Asian communities: A meta-analysis of randomised controlled trials. Psychol Psychother 2023; 96:148-171. [PMID: 36314962 PMCID: PMC10091769 DOI: 10.1111/papt.12431] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 09/20/2022] [Accepted: 09/28/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE Practising compassion increases well-being and reduces depression, anxiety, and psychological distress among clinical and non-clinical populations. There is a rapid increase in compassion-based interventions within the past two decades. However, the reviews are limited to predominantly Western cultures. Therefore, this meta-analysis aimed to evaluate the literature attempting to promote and increase compassion in Asian communities. METHOD Eight randomised controlled trials (RCTs) conducted between 2016 to 2021 were included in the meta-analysis with data from 1012 participants across Thailand, Japan, China and Hong Kong. Effect sizes were calculated to test the efficacy of the compassion-based interventions on the self-compassion outcome. Intervention efficacy was tested by comparing the intervention groups against control groups (wait-list control and active control groups) at pre- and post-interventions. RESULTS Significant between-group differences in change scores were found on self-report measures of self-compassion with large effect sizes in interventions with wait-list control groups (d = .86) and small effect sizes in interventions with active-control groups (d = .19). CONCLUSIONS Although compassion-based interventions are heterogeneous in nature and limited in scope, there is promising evidence of improving self-compassion in Asian communities. This supports for the cross-cultural applicability of compassion-based interventions. However, research within the Asian context is limited and at an infancy stage, signifying the importance of conducting further compassion-based interventions in clinical and non-clinical groups living in the Asian communities.
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Affiliation(s)
| | | | | | - Sarah E Kirby
- Department of Psychology, University of Southampton, Southampton, UK
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Kariyawasam L, Ononaiye M, Irons C, Kirby SE. Exploring the Cross-cultural Applicability of a Brief Compassionate Mind Training: a Study Comparing Sri Lankan and UK People. Mindfulness (N Y) 2022; 14:429-447. [PMID: 36575653 PMCID: PMC9782273 DOI: 10.1007/s12671-022-02041-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/03/2022] [Indexed: 12/24/2022]
Abstract
Objectives Compassionate Mind Training (CMT) is a therapeutic approach proven to be effective for reducing distress and increasing well-being in clinical and non-clinical populations. This study aimed to explore the efficacy of a short-term, online version of the CMT on compassion, distress, and well-being in a cross-cultural, non-clinical sample of Sri Lankan and UK people. Method A randomized controlled trial with pre-, post-measurements, and a 2-week follow-up was conducted using CMT (n = 21 Sri Lankan, n = 73 UK) and wait-list control (n = 17 Sri Lankan, n = 54 UK) groups. The intervention effects were investigated using a series of repeated-measures ANOVAs using intention-to-treat and per-protocol analyses. Results The 2-week CMT was effective in increasing all aspects of compassion in both Sri Lankan and UK people. In addition, some cross-cultural similarities and differences (in the factors affecting compassion) were present in the improvements following CMT between the two countries, which were maintained at a 2-week follow-up. Conclusion This study provides promising evidence for the efficacy and cross-cultural applicability of CMT for reducing distress and increasing well-being.
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Affiliation(s)
- Lasara Kariyawasam
- University of Southampton, Highfield Campus, University Road, Southampton, SO17 1BJ UK
| | | | | | - Sarah E. Kirby
- Academic Unit of Psychology, University of Southampton, Southampton, UK
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Kariyawasam L, Ononaiye M, Irons C, Stopa L, Kirby SE. Views and experiences of compassion in Sri Lankan students: An exploratory qualitative study. PLoS One 2021; 16:e0260475. [PMID: 34818344 PMCID: PMC8612518 DOI: 10.1371/journal.pone.0260475] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 11/10/2021] [Indexed: 12/30/2022] Open
Abstract
Practicing compassion has shown to reduce distress and increase emotional well-being in clinical and non-clinical populations. The existing research is primarily focused on Western populations although the concepts of compassion are heavily influenced by Asian Buddhist views. There is a dearth of compassion research conducted particularly in the Asian context. Therefore, this study aimed to explore the views and lived experiences of compassion in Sri Lankan students, to understand whether compassion is a socially embraced construct in Sri Lanka, considering that Sri Lanka is a Buddhist influenced society. Participants' views and lived experiences of compassion towards themselves and to/from others were also investigated, with a specific focus on their perceived inhibitors and facilitators of compassion. Aims were set to identify whether Western compassion-based practices could be successfully applied to Asian societies such as Sri Lanka. An Interpretative Phenomenological Analysis approach was used to obtain and analyse qualitative data from a convenience sample of 10 Sri Lankan students, recruited from a Psychology course. The phenomenological analysis of the semi-structured face-to-face interviews elicited three predominant themes: What compassion means to me, what I make of it, and compassion through facilitators and inhibitors. The findings suggested that participants shared a similar understanding of the concept of compassion as reflected in the Western definitions. Experiences and views of compassion were shaped by several factors including religion, culture, society, and upbringing. In general, this study revealed that participants were well aware of the concept of compassion as well as its impact on their psychological well-being. Despite this, inhibitors existed in experiencing compassion. The religious and collectivistic-cultural influences need to be further explored and taken into account when implementing Western compassion-based practices to non-Western contexts such as Sri Lanka.
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Affiliation(s)
- Lasara Kariyawasam
- Department of Psychology, University of Southampton, Southampton, United Kingdom
- * E-mail:
| | - Margarita Ononaiye
- Department of Psychology, University of Southampton, Southampton, United Kingdom
| | - Chris Irons
- Balanced Minds, London Islington, London, United Kingdom
| | - Lusia Stopa
- Department of Psychology, University of Southampton, Southampton, United Kingdom
| | - Sarah E. Kirby
- Department of Psychology, University of Southampton, Southampton, United Kingdom
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Stanescu S, Kirby SE, Thomas M, Yardley L, Ainsworth B. A systematic review of psychological, physical health factors, and quality of life in adult asthma. NPJ Prim Care Respir Med 2019; 29:37. [PMID: 31636268 PMCID: PMC6803647 DOI: 10.1038/s41533-019-0149-3] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 09/24/2019] [Indexed: 02/07/2023] Open
Abstract
Asthma is a common non-communicable disease, often characterized by activity limitation, negative effects on social life and relationships, problems with finding and keeping employment, and poor quality of life. The objective of the present study was to conduct a systematic review of the literature investigating the potential factors impacting quality of life (QoL) in asthma. Electronic searches were carried out on: MEDLINE, EMBASE, PsycINFO, the Cochrane Library, and Web of Science (initial search April 2017 and updated in January 2019). All primary research studies including asthma, psychological or physical health factors, and quality of life were included. Narrative synthesis was used to develop themes among findings in included studies in an attempt to identify variables impacting QoL in asthma. The search retrieved 43 eligible studies that were grouped in three themes: psychological factors (including anxiety and depression, other mental health conditions, illness representations, and emotion regulation), physical health factors (including BMI and chronic physical conditions), and multifactorial aspects, including the interplay of health and psychological factors and asthma. These were found to have a substantial impact on QoL in asthma, both directly and indirectly, by affecting self-management, activity levels and other outcomes. Findings suggest a complex and negative effect of health and psychological factors on QoL in asthma. The experience of living with asthma is multifaceted, and future research and intervention development studies should take this into account, as well as the variety of variables interacting and affecting the person.
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Affiliation(s)
- Sabina Stanescu
- Academic Unit of Psychology, University of Southampton, Southampton, UK.
| | - Sarah E Kirby
- Academic Unit of Psychology, University of Southampton, Southampton, UK.,NIHR Southampton Respiratory Biomedical Research Unit, University of Southampton, Southampton, UK
| | - Mike Thomas
- NIHR Southampton Respiratory Biomedical Research Unit, University of Southampton, Southampton, UK.,Primary Care and Population Sciences, University of Southampton, Southampton, UK
| | - Lucy Yardley
- Academic Unit of Psychology, University of Southampton, Southampton, UK
| | - Ben Ainsworth
- Department of Psychology, University of Bath, Bath, UK
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Arden-Close EJ, Kirby SE, Yardley L, Bruton A, Ainsworth B, Thomas DM. Evaluation of a breathing retraining intervention to improve quality of life in asthma: quantitative process analysis of the BREATHE randomized controlled trial. Clin Rehabil 2019; 33:1139-1149. [PMID: 30813767 DOI: 10.1177/0269215519832942] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Explore qualitative differences between interventions (DVD and booklet (DVDB) versus face-to-face and booklet (F2FB) versus usual care) in the BREATHE (Breathing Retraining for Asthma Trial of Home Exercises) trial of breathing retraining for asthma. DESIGN Quantitative process analysis exploring group expectancy, experience and practice before and after intervention delivery for the main trial. SETTING Primary care. SUBJECTS Adults with asthma (DVD and booklet, n = 261; F2FB, n = 132). MAIN MEASURES Baseline - expectancy about breathing retraining; follow-up 3, 6 and 12 months - self-efficacy, treatment experience (enjoyment of treatment, perceptions of physiotherapist, perceptions of barriers), amount of practice (weeks, days/week, times/day), continued practice; all time points - anxiety (Hospital Anxiety and Depression Scale), AQLQ (Asthma Quality of Life Questionnaire). RESULTS No group differences in baseline expectancy. Statistically significant results (P < 0.05) indicated that at follow-up, F2FB participants perceived greater need for a physiotherapist than DVD and booklet participants (3.43 (0.87) versus 2.15 (1.26)). F2FB participants reported greater enjoyment of core techniques (such as stomach breathing: 7.42 (1.67) versus 6.13 (1.99) (DVD and booklet)). Fewer F2FB participants reported problems due to doubts (24 (22.9%) versus 90 (54.2%)). F2FB participants completed more practice sessions (75.01 (46.38) versus 48.56 (44.71)). Amount of practice was not significantly related to quality of life. In the DVD and booklet arm, greater confidence in breathing retraining ability explained 3.9% of variance in quality of life at 12 months. CONCLUSION Adults with asthma receiving breathing retraining face-to-face report greater enjoyment and undertaking more practice than those receiving a DVD and booklet. Greater confidence in ability to do breathing retraining is associated with improved QoL.
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Affiliation(s)
| | - Sarah E Kirby
- 2 Academic Unit of Psychology, University of Southampton, Southampton, UK
| | - Lucy Yardley
- 2 Academic Unit of Psychology, University of Southampton, Southampton, UK.,3 School of Experimental Psychology, University of Bristol, Bristol, UK
| | - Anne Bruton
- 4 Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Ben Ainsworth
- 2 Academic Unit of Psychology, University of Southampton, Southampton, UK.,5 Primary Care and Population Sciences, University of Southampton, Southampton, UK.,6 Department of Psychology, University of Bath, Bath, UK
| | - D Mike Thomas
- 5 Primary Care and Population Sciences, University of Southampton, Southampton, UK
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Miles C, Arden-Close E, Thomas M, Bruton A, Yardley L, Hankins M, Kirby SE. Barriers and facilitators of effective self-management in asthma: systematic review and thematic synthesis of patient and healthcare professional views. NPJ Prim Care Respir Med 2017; 27:57. [PMID: 28993623 PMCID: PMC5634481 DOI: 10.1038/s41533-017-0056-4] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Revised: 09/05/2017] [Accepted: 09/07/2017] [Indexed: 11/09/2022] Open
Abstract
Self-management is an established, effective approach to controlling asthma, recommended in guidelines. However, promotion, uptake and use among patients and health-care professionals remain low. Many barriers and facilitators to effective self-management have been reported, and views and beliefs of patients and health care professionals have been explored in qualitative studies. We conducted a systematic review and thematic synthesis of qualitative research into self-management in patients, carers and health care professionals regarding self-management of asthma, to identify perceived barriers and facilitators associated with reduced effectiveness of asthma self-management interventions. Electronic databases and guidelines were searched systematically for qualitative literature that explored factors relevant to facilitators and barriers to uptake, adherence, or outcomes of self-management in patients with asthma. Thematic synthesis of the 56 included studies identified 11 themes: (1) partnership between patient and health care professional; (2) issues around medication; (3) education about asthma and its management; (4) health beliefs; (5) self-management interventions; (6) co-morbidities (7) mood disorders and anxiety; (8) social support; (9) non-pharmacological methods; (10) access to healthcare; (11) professional factors. From this, perceived barriers and facilitators were identified at the level of individuals with asthma (and carers), and health-care professionals. Future work addressing the concerns and beliefs of adults, adolescents and children (and carers) with asthma, effective communication and partnership, tailored support and education (including for ethnic minorities and at risk groups), and telehealthcare may improve how self-management is recommended by professionals and used by patients. Ultimately, this may achieve better outcomes for people with asthma.
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Affiliation(s)
- Clare Miles
- Academic Unit of Psychology, University of Southampton, Highfield, Southampton, SO17 1BJ, UK
| | | | - Mike Thomas
- Primary Care and Population Sciences, University of Southampton, Southampton, UK
- NIHR Southampton Respiratory Biomedical Research Unit, University of Southampton, Southampton, UK
| | - Anne Bruton
- NIHR Southampton Respiratory Biomedical Research Unit, University of Southampton, Southampton, UK
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Lucy Yardley
- Academic Unit of Psychology, University of Southampton, Highfield, Southampton, SO17 1BJ, UK
| | | | - Sarah E Kirby
- Academic Unit of Psychology, University of Southampton, Highfield, Southampton, SO17 1BJ, UK.
- NIHR Southampton Respiratory Biomedical Research Unit, University of Southampton, Southampton, UK.
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Kirby SE, Yardley L. Physical and psychological triggers for attacks in Ménière's disease: the patient perspective. Psychother Psychosom 2013; 81:396-8. [PMID: 23007998 DOI: 10.1159/000337114] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Accepted: 02/07/2012] [Indexed: 11/19/2022]
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Abstract
Previous studies have identified that spiritual beliefs contribute to psychological well-being (PWB) in older people, but limited research has considered the effects of spirituality on PWB when physical health deteriorates and people become frail. We recruited 233 British participants from warden-controlled retirement housing to complete interviewer-administered questionnaires. Results showed that, after we controlled for marital status, age, education, other health problems, and gender, degree of frailty had a negative effect on PWB. Spirituality was also a significant predictor of PWB and moderated the negative effects of frailty on PWB. Therefore, this study suggests that spirituality is a resource in maintaining PWB, and that the use of this resource is more significant for individuals with greater levels of frailty.
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Affiliation(s)
- Sarah E Kirby
- School of Psychology, University of Southampton, England
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