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Gathright EC, Hughes JW, Sun S, Storlazzi LE, DeCosta J, Balletto BL, Carey MP, Scott-Sheldon LAJ, Salmoirago-Blotcher E. Effects of stress management interventions on heart rate variability in adults with cardiovascular disease: a systematic review and meta-analysis. J Behav Med 2024; 47:374-388. [PMID: 38478157 DOI: 10.1007/s10865-024-00468-4] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 01/15/2024] [Indexed: 04/19/2024]
Abstract
Meta-analysis was used to investigate the potential benefits of stress management interventions (SMIs) on vagally-mediated heart rate variability (HRV) in adults with cardiovascular disease. Electronic bibliographic databases were searched through August 2022. Randomized controlled trials and quasi-experimental studies assessing effects of SMIs on HRV were included. Methodological quality was assessed with a standardized checklist. A pooled effect size was calculated for vagally-mediated HRV indices (standard deviation of normal-to-normal intervals, root mean square of the successive differences, and high frequency power) using random effects models. Fourteen studies (1202 participants, Mage: 59 ± 6.25 years; 25% ± 16% women; 61% ± 22% White) were included. Ten studies (11 effects) reported short-term HRV assessment; a small between-group difference emerged for vagally-mediated HRV (d+ = .27, 95% confidence interval [CI] 0.01-0.52, k = 11). Most interventions examined biofeedback; these studies yielded a small between-group difference on vagally-mediated HRV (d+ = 0.31, 95% CI 0.09-0.53, k = 7, Q [6] = 3.82, p = .70, I2 = 11%). This is the first systematic examination of the effect of SMIs on HRV in adults with CVD. Findings suggest a small effect of SMIs on vagally-mediated HRV, with biofeedback likely driving the effect. More research is required to fully understand whether this benefit on vagally-mediated HRV applies to other SMIs.
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Affiliation(s)
- Emily C Gathright
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, CORO West, Suite 309, 164 Summit Avenue, Providence, RI, 02906, USA.
- Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, RI, USA.
| | - Joel W Hughes
- Department of Psychological Sciences, Kent State University, Kent, OH, USA
| | - Shufang Sun
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Laurie E Storlazzi
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, CORO West, Suite 309, 164 Summit Avenue, Providence, RI, 02906, USA
| | - Julie DeCosta
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, CORO West, Suite 309, 164 Summit Avenue, Providence, RI, 02906, USA
| | - Brittany L Balletto
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, CORO West, Suite 309, 164 Summit Avenue, Providence, RI, 02906, USA
| | - Michael P Carey
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, CORO West, Suite 309, 164 Summit Avenue, Providence, RI, 02906, USA
- Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, RI, USA
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Lori A J Scott-Sheldon
- Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, RI, USA
| | - Elena Salmoirago-Blotcher
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, CORO West, Suite 309, 164 Summit Avenue, Providence, RI, 02906, USA
- Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, RI, USA
- Department of Medicine, Alpert School of Medicine, Brown University, Providence, RI, USA
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Ahuja N, Bhardwaj P, Pathania M, Sethi D, Kumar A, Parchani A, Chandel A, Phadke A. Yoga Nidra for hypertension: A systematic review and meta-analysis. J Ayurveda Integr Med 2024; 15:100882. [PMID: 38484438 PMCID: PMC10950755 DOI: 10.1016/j.jaim.2023.100882] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 10/05/2023] [Accepted: 12/15/2023] [Indexed: 03/24/2024] Open
Abstract
BACKGROUND Hypertension is a prevalent chronic condition that affects a substantial proportion of the world's population. Medications are commonly prescribed for hypertension management, but non-pharmacological interventions like yoga are gaining popularity. OBJECTIVE The purpose of this systematic review and meta-analysis is to assess the efficacy of Yoga Nidra (YN) for the management of hypertension. METHODS A systematic review and meta-analysis of clinical trials, i.e., non-randomized and randomized controlled trials (RCTs) was conducted to investigate the effects of YN on hypertension. PubMed, the Cochrane Library, SCOPUS, and EBSCO were searched for relevant studies published up to September 2022. The quality of the included studies was assessed using the Cochrane risk of bias tool. The primary outcome measure was the change in systolic blood pressure (SBP) and diastolic blood pressure (DBP) after YN intervention, analyzed as weighted mean difference (WMD), in comparison to control groups. The random-effects model was used for the meta-analysis. Risk of bias was assessed for RCTs and non-RCTs using Cochrane's RoB-2 and ROBINS-I tools, respectively. RESULTS Five RCTs and three Non-RCTs involving a total of 482 participants (239 for YN vs 243 for controls) were included in this review. The meta-analysis indicated that YN significantly reduced SBP (WMD = 12.03 mm Hg, 95% CI [7.12, 16.93], Z = 4.80, p < 0.00001) and DBP (WMD = 6.32 mm Hg, 95% CI [3.53, 9.12], Z = 4.43, p < 0.00001) compared to control groups. The overall risk of bias for the three RCTs was high, whereas for the five non-RCTs, one had an overall moderate risk while the other four had an overall serious risk of bias. DISCUSSION This systematic review and meta-analysis provides evidence supporting the efficacy of YN as a complementary therapy for hypertension management. YN is a safe, cost-effective, and easily accessible intervention that primarily relies on interoception and induces a deep relaxation response in practitioners, aiding them in coping with various components of high blood pressure, such as stress, vascular inflammation, peripheral vascular resistance, etc. Our understanding of the mechanisms of YN is constantly evolving, and there is a need for further research to fully explore and appreciate the significance of this ancient science and its potential efficacy on BP. Considering the results and the multifactorial role of YN, it can act as a safe and reliable adjuvant therapy to complement the pharmacological treatment of hypertension. However, further studies with larger sample sizes, longer follow-up periods, and homogenous populations are warranted. CONCLUSION This meta-analysis suggests that YN is effective in reducing SBP and DBP, particularly in individuals with hypertension. The results highlight the potential of YN as a complementary therapy for hypertension management. Healthcare providers may consider recommending YN to patients with hypertension as an adjuvant therapy to medication. Further studies are required to identify standardized optimal forms and durations of YN best suited for hypertension management.
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Affiliation(s)
- Navdeep Ahuja
- Dept. of Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Praag Bhardwaj
- Dept. of Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Monika Pathania
- Dept. of Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
| | - Dilasha Sethi
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana - SVYASA, Bangaluru, Karnataka, India
| | - Arjun Kumar
- Dept. of Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Ashwin Parchani
- Dept. of Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Akshita Chandel
- Dept. of General Medicine, All India Institute of Medical Sciences, Bilaspur, Himachal Pradesh, India
| | - Aashish Phadke
- Division of Endocrine and Metabolic Disorders - Lifestyle Modulations and Yoga Modules, Kasturba Health Society - Medical Research Centre, Mumbai, Maharashtra, India
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Di Nota PM, Scott SC, Huhta JM, Gustafsberg H, Andersen JP. Physiological Responses to Organizational Stressors Among Police Managers. Appl Psychophysiol Biofeedback 2024; 49:85-102. [PMID: 38244109 PMCID: PMC10869394 DOI: 10.1007/s10484-023-09613-2] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2023] [Indexed: 01/22/2024]
Abstract
Police officers demonstrate increased risk of physical and mental health conditions due to repeated and prolonged exposure to stressful occupational conditions. Occupational stress is broken into two types: operational stress, related to the content of field duties (e.g., physical demands); and organizational stress, related to cultural and structural contexts (e.g., interpersonal relationships). Applied police research focuses on physiological activation in operational tasks as a mechanism explaining health risk and non-optimal performance outcomes. However, recent survey-based studies indicate numerous organizational stressors associated with self-reported mental health symptoms. The question of whether organizational stressors elicit significant physiological activity remains unknown. The current proof-of-concept field study tests the hypothesis that police managers will display significant physiological reactivity before, during, and after engaging in reality-based scenarios representative of stressful police management tasks developed from evidence-based pedagogical approaches. A sample of 25 training police managers (7 female, M = 16 +/- 5.3 years of experience) completed 5 reality-based scenarios, including resolving a heated conflict between colleagues, delivering negative feedback to a subordinate, and critical incident command. Significant increases in heart rate relative to rest were observed during all tasks, and in anticipation of several tasks. Greater increases in reactive heart rate were associated with longer recovery times. Sex differences and relationships between objective biological and subjective psychological measures of stress are discussed. The current findings demonstrate significant physiological responses to organizational stressors similar to levels observed during operational tasks, despite the absence of physical or aerobic exertion. Implications for police health and training are discussed.
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Affiliation(s)
- Paula M Di Nota
- Department of Psychology, University of Toronto Mississauga, Mississauga, ON, Canada
| | - Sarah C Scott
- Department of Psychology, University of Toronto Mississauga, Mississauga, ON, Canada
| | - Juha-Matti Huhta
- Police University College of Finland, Tampere, Finland
- Faculty of Culture & Education, Tampere University, Tampere, Finland
| | | | - Judith P Andersen
- Department of Psychology, University of Toronto Mississauga, Mississauga, ON, Canada.
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Nebhinani N, Kuppili PP, Mamta. Feasibility and effectiveness of stress management skill training in medical students. Med J Armed Forces India 2024; 80:140-144. [PMID: 38525462 PMCID: PMC10954490 DOI: 10.1016/j.mjafi.2021.10.007] [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] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 10/06/2021] [Indexed: 11/24/2022] Open
Abstract
Background There is limited literature on stress management interventions targeting Indian medical undergraduates. With this background, the study aimed to evaluate the feasibility and effectiveness of stress management intervention on perceived stress, coping and burnout amongst first-year medical undergraduates. Methods It was a quasi-experimental study assessing the effect of "Comprehensive Stress Management Skill Training Program". This intervention emphasized on self-awareness of early warning signs of stress, adopting a healthy lifestyle, developing assertiveness at work, maintaining work-life balance. The stress reduction techniques mainly consisted of deep breathing exercises, progressive muscular relaxation and visualization. It was delivered by a team of a psychiatrist and a nurse to hundred first year medical undergraduate students. Medical Students Stressor Questionnaire, Brief COPE Questionnaire and Maslach Burnout Inventory-Student Survey were applied for assessment of perceived stress, burn out, and coping, respectively, at baseline, finish of one and three months of intervention. Results Significant improvement was noted in academic stress, interpersonal-related stress, teaching learning-related stress, and total stress scores, emotional exhaustion, and emotion-focused coping at the end of the three months of intervention. Positive feedback about the intervention was given by majority of the students. Conclusion Stress management intervention was found to be feasible and effective in improving stress, coping, and emotional exhaustion in first year medical students.
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Affiliation(s)
- Naresh Nebhinani
- Additional Professor (Psychiatry), All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Pooja Patnaik Kuppili
- Senior Clinical Fellow, Black Country Healthcare Foundation NHS Trust, United Kingdom
| | - Mamta
- Lecturer, College of Nursing, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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Ruchiwit M, Vuthiarpa S, Ruchiwit K, Muijeen K, Phanphairoj K. A Synthesized Model for Applying Stress Management and Biofeedback Interventions in Research Utilization: A Systematic Review and Meta-analysis. Clin Pract Epidemiol Ment Health 2024; 20:e17450179276691. [PMID: 38660573 PMCID: PMC11037511 DOI: 10.2174/0117450179276691231229071003] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 11/01/2023] [Accepted: 11/08/2023] [Indexed: 04/26/2024]
Abstract
Background Stress management and biofeedback interventions have been shown to be effective in improving mental and physical health outcomes. However, previous research studies and synthesized models for applying these interventions in research utilization are insufficient. Objective This study aimed to synthesize a model for applying stress management and biofeedback interventions in research utilization. Methods A systematic review and meta-analysis were conducted according to the PRISMA guidelines.Multiple studies were used to assess the effectiveness of applying stress management and biofeedback interventions published from 2017 to 2023. The process included identifying the research questions, conducting a comprehensive literature search, assessing study quality, extracting data, synthesizing the data, analyzing and interpreting the findings, drawing conclusions, and making recommendations. Results The results indicated a significant mean effect size without evidence of publication bias. The effect sizes of the subgroups among the study variables were not significantly different [Q = 4.02, p = .26]. However, there were significant differences regarding the mean effect sizes among the studies [Q = 63.59, p < .001] and also in terms of the test of subgroups among the participants [Q = 8.49, p = .04]. Conclusion The results emphasize the importance of evidence-based practice and highlight the need for ongoing evaluation and refinement of interventions. The proposed model was supported by related theories and research studies in order to ensure the robustness and reliability to guide practice and future research in the field of biofeedback interventions. By following this model, researchers and practitioners can ensure that stress management and biofeedback interventions are evidence-based and are effective in improving mental and physical health outcomes.
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Affiliation(s)
- Manyat Ruchiwit
- Faculty of Nursing, Rattana Bundit University, Pathumthani, Thailand
| | - Sararud Vuthiarpa
- Faculty of Nursing, Rattana Bundit University, Pathumthani, Thailand
| | - Kampol Ruchiwit
- Faculty of Allied Health Sciences, Thammasat University, Pathumthani, Thailand
| | - Kasorn Muijeen
- Faculty of Nursing, Thammasat University, Pathumthani, Thailand
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Gong R, Heller A, Patricia I Moreno, Betina Yanez, Penedo FJ. Low Social Well-Being in Advanced and Metastatic Prostate Cancer: Effects of a Randomized Controlled Trial of Cognitive Behavioral Stress Management. Int J Behav Med 2024:10.1007/s12529-024-10270-w. [PMID: 38378974 DOI: 10.1007/s12529-024-10270-w] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND Social well-being impacts cancer patients' health-related quality of life (HRQOL) and coping style. This secondary analysis was conducted to examine whether advanced prostate cancer survivors who had experienced low social well-being would benefit from a web-based cognitive behavioral stress management (CBSM) intervention. METHOD APC survivors (N = 192) who had received androgen deprivation therapy (ADT) were randomized to a 10-week CBSM or a health promotion (HP) control condition. A subsample of participants (n = 61) with low pre-intervention SWB (measured by social support from and relationship satisfaction with family and friends) was included in the study. Multilevel models compared participants' PC-specific quality of life (sexual, hormonal, urinary), affect-based psychosocial burden (cancer-related anxiety and distress), and coping strategies at baseline, 6 months, and 12 months. Covariates were included in all models as appropriate. RESULTS Participants randomized to the CBSM condition showed significantly greater improvements in fear of cancer recurrence and cancer-related intrusive thoughts than those in the HP control condition. A significant condition by time interaction was also found, indicating that CBSM improved participants' PC-related fear in both short- (6 months) and long-term (12 months). However, the CBSM intervention did not significantly impact APC-related symptom burden. Only for the urinary domain, clinically meaningful changes (CBSM vs HP) were observed. In addition, all participants, regardless of condition, reported less coping (e.g., emotion-, problem- and avoidance-focused) over time. CONCLUSION As predicted, the CBSM intervention improved several affect-based psychosocial outcomes for APC survivors with low baseline SWB.
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Affiliation(s)
- Rui Gong
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA.
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA.
| | - Aaron Heller
- Department of Psychology, University of Miami, Coral Gables, Miami, FL, 33146, USA
| | - Patricia I Moreno
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Betina Yanez
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Frank J Penedo
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA.
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA.
- Department of Psychology, University of Miami, Coral Gables, Miami, FL, 33146, USA.
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Till B, Hofhansl A, Niederkrotenthaler T. Effects of the mental health promotion seminar 'Coping with stress' in the undergraduate medical curriculum of the Medical University of Vienna. BMC Med Educ 2024; 24:41. [PMID: 38191363 PMCID: PMC10773058 DOI: 10.1186/s12909-023-05019-0] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 12/29/2023] [Indexed: 01/10/2024]
Abstract
BACKGROUND High prevalence rates of distress and burnout in medical students are well-documented in mental health literature. Different types of interventions have been developed in the past in order to reduce stress in medical undergraduate students and promote better coping skills. There is, however, a paucity of studies that have tested the effectiveness of these interventions. This study aimed to examine the effect of different versions of the seminar 'Coping with stress', which was implemented in the first year of the undergraduate curriculum of the Medical University of Vienna in the summer semester of 2018, on students' mental health. METHODS Invitations to participate in the study were sent via email to six cohorts of students from the Medical University of Vienna. Two cohorts participated in the onsite version of the seminar 'Coping with stress', whereas two cohorts participated in the online version of the seminar, and two cohorts received no intervention (control group). Data on burnout risk, life satisfaction, stress, and knowledge about available help resources were collected via online questionnaires from n = 137 students before and after the curriculum module that contained the seminar. RESULTS Medical students who participated in the onsite seminar reported a reduction of some aspects of burnout, a decrease in stress, and an increase in knowledge about available help resources. No such effect was seen in the control group. Participants of the online seminar experienced a similar increase in knowledge about available help resources, but no changes in other outcomes. CONCLUSIONS The findings support the notion that the onsite seminar of 'Coping with stress' had a positive impact on medical students' mental health and is a useful addition to the medical curriculum by promoting mental health literacy. TRIAL REGISTRATION This research has been registered in the German Clinical Trial Registry with the registration number DRKS00018981 and the registration date 14/11/2019.
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Affiliation(s)
- Benedikt Till
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, Vienna, A-1090, Austria.
| | - Angelika Hofhansl
- Medical Didactics, Teaching Center, Medical University of Vienna, Vienna, Austria
| | - Thomas Niederkrotenthaler
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, Vienna, A-1090, Austria
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Penzien DB, Irby MB. Biobehavioral treatments of migraine. Handb Clin Neurol 2024; 199:155-169. [PMID: 38307643 DOI: 10.1016/b978-0-12-823357-3.00031-8] [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] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2024]
Abstract
Pharmacotherapies are the mainstays of migraine management, though it is not uncommon for them to be poorly tolerated, contraindicated, or only modestly effective. There is a clear need for nonpharmacologic migraine therapies, either employed alone or in combination with pharmacotherapies. Behavioral and psychosocial factors known to contribute to the onset, exacerbation, and persistence of primary headache disorders (e.g., stress, sleep, diet) serve as targets within a self-management model for migraine-a model that features headache pharmacotherapies, behavioral skills training, medication adherence facilitation, relevant lifestyle changes, and techniques to limit headache-related impairment. Behavioral self-management interventions for migraine with the strongest empirical validation (e.g., relaxation training, biofeedback training, cognitive-behavior therapies) presently are available in specialty headache treatment centers and routinely show promise for reducing headache pain frequency/severity and related impairment, reducing reliance on pharmacotherapies, enhancing personal control over headache activity, and reducing headache-related distress and symptoms. These approaches may be particularly well-suited among patients for whom pharmacotherapies are unwanted, poorly tolerated, or contraindicated. Though underutilized, clinical trials indicate that new and well-established behavioral therapies are similarly effective to migraine medications for migraine prevention among adults and can be successfully employed in various settings.
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Affiliation(s)
- Donald B Penzien
- Departments of Psychiatry and Behavioral Medicine, Neurology, & Epidemiology and Prevention, Wake Forest School of Medicine, Winston Salem, NC, United States.
| | - Megan B Irby
- Department of Health and Exercise Science, Wake Forest University, Winston Salem, NC, United States
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Himle JA, Grogan-Kaylor A, Hiller MA, Mannella KA, Norman LJ, Abelson JL, Prout A, Shunnarah AA, Becker HC, Russman Block SR, Taylor SF, Fitzgerald KD. Exposure and response prevention versus stress management training for adults and adolescents with obsessive compulsive disorder: A randomized clinical trial. Behav Res Ther 2024; 172:104458. [PMID: 38103359 DOI: 10.1016/j.brat.2023.104458] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 11/24/2023] [Accepted: 12/06/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVE Though exposure and response prevention (ERP) is a well-proven treatment for OCD across the lifespan, prior RCTs have not studied adolescent and adult patients with the same ERP protocol relative to an active comparator that controls for non-specific effects of treatment. This approach assesses differences in the effect of OCD-specific exposures in affected adolescents and adults and in response to ERP compared to a stress-management control therapy (SMT). METHODS This assessor-blinded, parallel, 2-arm, randomized, ambulatory clinical superiority trial randomized adolescents (aged 12-18) and adults (24-46) with OCD (N = 126) to 12 weekly sessions of ERP or SMT. OCD severity was measured before, during and after treatment using the child or adult version of the Yale-Brown Obsessive Compulsive Scale (C/Y-BOCS), depending on participant age. We predicted that ERP would produce greater improvement in OCD symptoms than SMT and that there would be no significant post-treatment differences across age groups. RESULTS ERP (n = 63) produced significantly greater improvements on C/Y-BOCS scores at post-treatment than SMT (n = 63) (Effect size = -0.72, CI = -0.52 to -0.91, p < .001). ERP also produced more treatment responders (ERP = 86%, SMT = 32%; χ2 = 46.37, p < .001) and remitters than SMT (ERP = 39%, SMT = 7%; χ2 = 16.14, p < .001). Finally, there were no statistically significant post-treatment differences in C/Y-BOCS scores between adolescents and adults assigned to ERP. CONCLUSION A single ERP protocol is superior to SMT in treating both adolescents and adults with OCD. OCD-specific therapy is necessary across the lifespan for optimal outcomes in this highly disabling disorder, though non-specific treatments like SMT are still all-too-commonly provided.
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Affiliation(s)
- Joseph A Himle
- School of Social Work, University of Michigan, 1080 South University Ave, Ann Arbor, MI, 48109, USA; Department of Psychiatry, Medical School, University of Michigan, 1500 East Medical Center Dr., Ann Arbor, MI, 48109, USA.
| | - Andrew Grogan-Kaylor
- School of Social Work, University of Michigan, 1080 South University Ave, Ann Arbor, MI, 48109, USA
| | - Matthew A Hiller
- School of Social Work, University of Michigan, 1080 South University Ave, Ann Arbor, MI, 48109, USA
| | - Kristin A Mannella
- Department of Psychiatry, Medical School, University of Michigan, 1500 East Medical Center Dr., Ann Arbor, MI, 48109, USA
| | - Luke J Norman
- Department of Psychiatry, Medical School, University of Michigan, 1500 East Medical Center Dr., Ann Arbor, MI, 48109, USA
| | - James L Abelson
- Department of Psychiatry, Medical School, University of Michigan, 1500 East Medical Center Dr., Ann Arbor, MI, 48109, USA
| | - Aileen Prout
- Department of Psychiatry, Medical School, University of Michigan, 1500 East Medical Center Dr., Ann Arbor, MI, 48109, USA
| | - Angela A Shunnarah
- Department of Psychiatry, Medical School, University of Michigan, 1500 East Medical Center Dr., Ann Arbor, MI, 48109, USA
| | - Hannah C Becker
- Department of Psychiatry, Medical School, University of Michigan, 1500 East Medical Center Dr., Ann Arbor, MI, 48109, USA
| | - Stefanie R Russman Block
- Department of Psychiatry, Medical School, University of Michigan, 1500 East Medical Center Dr., Ann Arbor, MI, 48109, USA
| | - Stephan F Taylor
- Department of Psychiatry, Medical School, University of Michigan, 1500 East Medical Center Dr., Ann Arbor, MI, 48109, USA
| | - Kate D Fitzgerald
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, 630 W 168th St, New York, NY, 10032, USA
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August KJ, Malik D, Markey CH, Woods K, Gerwitz GC. Additive and interactive associations among body appreciation, self-compassion, and gender in understanding college students' health behaviors. Body Image 2023; 47:101634. [PMID: 37774424 DOI: 10.1016/j.bodyim.2023.101634] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 09/12/2023] [Accepted: 09/19/2023] [Indexed: 10/01/2023]
Abstract
Body appreciation and self-compassion are associated with each other and individually associated with important health behaviors. Less is known about their combined associations with health behaviors, although previous work has examined self-compassion as a moderator of negative body image experiences. Self-compassion may likewise amplify the positive association between body appreciation and engagement in healthy behaviors. In this study, we examined the additive and interactive associations of body appreciation and self-compassion with three health behaviors (physical activity, sleep, stress management activities) among 302 college students from a northeastern university in the United States. We further examined gender differences in key variables and in associations among body appreciation, self-compassion, and health behaviors. We found that body appreciation was independently associated with physical activity and stress management activities, with the association stronger for men than women. We also found that self-compassion was independently associated with sleep and stress management activities. Body appreciation and self-compassion did not interact in predicting any health behaviors. Findings from this study highlight the unique associations of body appreciation and self-compassion with different health behaviors and underscore the need to increase body appreciation and self-compassion among college students to promote overall health and well-being.
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Affiliation(s)
- Kristin J August
- Departments of Psychology and Health Sciences and Graduate Program in Prevention Science, Rutgers University, Camden, United States.
| | - Dua Malik
- Graduate Program in Prevention Science, Rutgers University, Camden, United States
| | - Charlotte H Markey
- Departments of Psychology and Health Sciences and Graduate Program in Prevention Science, Rutgers University, Camden, United States
| | - Kristen Woods
- Department of Psychology, Rutgers University, Camden, United States
| | - Geneva C Gerwitz
- Office of Human Research, Thomas Jefferson University, United States
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Bernhart JA, Fellers AW, Wilson MJ, Hutto B, Bailey S, Turner-McGrievy GM. COVID-19 Pandemic Associations on Mental and Physical Health in African Americans Participating in a Behavioral Intervention. J Racial Ethn Health Disparities 2023; 10:3070-3076. [PMID: 36469289 PMCID: PMC9734885 DOI: 10.1007/s40615-022-01481-6] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 11/01/2022] [Accepted: 11/23/2022] [Indexed: 12/12/2022]
Abstract
The COVID-19 pandemic has had disproportionate effects on communities of color, with higher death rates among African Americans (AA). The purpose of this study was to assess associations in African Americans' mental and physical health with the COVID-19 pandemic. Data for this study came from a larger nutrition intervention of AAs in the Southeastern United States, the Nutritious Eating with Soul study. Data collected before and after March 15, 2020 (the day when local South Carolina schools and businesses closed), were analyzed to assess the association of the pandemic on participants' stress, control of healthy eating, physical activity, and body mass index. Repeated measures analysis of covariance using full maximum likelihood estimation to handle missing data was used. At the onset of the COVID-19 pandemic, 150 participants were enrolled in the study (48.2 ± 10.6 years old, 79% female, 75% with college degree or higher). Participants' reporting of stress did not show statistically significant change over time. Cognitive control increased 1.43 points (F = 20.60, p < 0.0001) and body mass index increased 0.72 kg/m2 (F = 10.68, p = 0.001). Future longitudinal studies should investigate how the COVID-19 pandemic continues to present challenges to understanding and improving health among African Americans. The study is registered at www.clinicaltrials.gov NCT03354377.
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Affiliation(s)
- J A Bernhart
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Room 536, 915 Greene Street, SC, 29208, Columbia, USA.
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC, 29208, USA.
| | - A W Fellers
- University of South Carolina School of Medicine, 6439 Garners Ferry Road, Columbia, SC, 29209, USA
| | - M J Wilson
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC, 29208, USA
- Department of Health Services, Policy, and Management, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, USA
| | - B Hutto
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC, 29208, USA
| | - S Bailey
- Department of Health Services, Policy, and Management, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, USA
| | - G M Turner-McGrievy
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Room 536, 915 Greene Street, SC, 29208, Columbia, USA
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12
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Riches S, Nicholson SL, Fialho C, Little J, Ahmed L, McIntosh H, Kaleva I, Sandford T, Cockburn R, Odoi C, Azevedo L, Vasile R, Payne-Gill J, Fisher HL, van Driel C, Veling W, Valmaggia L, Rumball F. Integrating a virtual reality relaxation clinic within acute psychiatric services: A pilot study. Psychiatry Res 2023; 329:115477. [PMID: 37802013 DOI: 10.1016/j.psychres.2023.115477] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 09/06/2023] [Accepted: 09/09/2023] [Indexed: 10/08/2023]
Abstract
People with acute psychiatric conditions experience heightened stress, which is associated with worsened symptoms and increased violence on psychiatric wards. Traditional stress management techniques can be challenging for patients. Virtual reality (VR) relaxation appears promising to reduce stress; however, research on VR for psychiatric wards is limited. This mixed-methods study investigated feasibility and acceptability of integrating a VR relaxation clinic within acute psychiatric services. The study evaluated a VR relaxation session for inpatients and outpatients with acute psychiatric conditions (N = 42) and therapists' (N = 6) experience facilitating VR sessions for patients. Self-report assessments of psychological wellbeing were completed by patients pre- and post-VR. Patients and therapists provided qualitative feedback. The number of violent incidents and restrictive practices on the wards in the 12 weeks before VR implementation was compared to the first 12 weeks of VR. Post-VR, there were statistically significant increases in patients' relaxation, happiness, and connectedness to nature, and decreases in stress, anxiety, and sadness. Qualitative findings indicate patients found sessions enjoyable, relaxing, and helpful. Therapists provided positive feedback but highlighted practical challenges. Violent incidents and restrictive practices halved during VR implementation. VR relaxation appears feasible and acceptable in acute services. Larger studies should evaluate potential impact on psychiatric wards.
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Affiliation(s)
- Simon Riches
- King's College London, Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, London SE5 8AF, United Kingdom; King's College London, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London SE5 8AF, United Kingdom; South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent BR3 3BX, United Kingdom.
| | - Sarah L Nicholson
- King's College London, Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, London SE5 8AF, United Kingdom; South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent BR3 3BX, United Kingdom
| | - Carolina Fialho
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent BR3 3BX, United Kingdom; King's College London, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, London SE5 8AF, United Kingdom
| | - Jordan Little
- King's College London, Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, London SE5 8AF, United Kingdom; South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent BR3 3BX, United Kingdom
| | - Lava Ahmed
- King's College London, Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, London SE5 8AF, United Kingdom; South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent BR3 3BX, United Kingdom
| | - Harley McIntosh
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent BR3 3BX, United Kingdom; King's College London, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, London SE5 8AF, United Kingdom
| | - Ina Kaleva
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent BR3 3BX, United Kingdom; King's College London, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, London SE5 8AF, United Kingdom
| | - Tom Sandford
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent BR3 3BX, United Kingdom
| | - Rebecca Cockburn
- King's College London, Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, London SE5 8AF, United Kingdom; South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent BR3 3BX, United Kingdom
| | - Clarissa Odoi
- King's College London, Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, London SE5 8AF, United Kingdom; South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent BR3 3BX, United Kingdom
| | - Lisa Azevedo
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent BR3 3BX, United Kingdom
| | - Ruxandra Vasile
- The Oxford Institute of Clinical Psychology Training and Research, Oxford Health NHS Foundation Trust and University of Oxford, Isis Education Centre, Warneford Hospital, Oxford OX3 7JX, United Kingdom
| | - James Payne-Gill
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent BR3 3BX, United Kingdom
| | - Helen L Fisher
- King's College London, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London SE5 8AF, United Kingdom; ESRC Centre for Society and Mental Health, King's College London, London WC2B 6NR, United Kingdom
| | - Catheleine van Driel
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Groningen, the Netherlands
| | - Wim Veling
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Groningen, the Netherlands
| | - Lucia Valmaggia
- King's College London, Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, London SE5 8AF, United Kingdom; South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent BR3 3BX, United Kingdom; KU Leuven, Department of Clinical Psychiatry, Leuven, Belgium
| | - Freya Rumball
- King's College London, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London SE5 8AF, United Kingdom; Oxleas Adult Autism Service, Oxleas NHS Foundation Trust, Kent DA2 7WG, United Kingdom
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13
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Walrabenstein W, Wagenaar CA, van de Put M, van der Leeden M, Gerritsen M, Twisk JWR, van der Esch M, van Middendorp H, Weijs PJM, Roorda LD, van Schaardenburg D. A multidisciplinary lifestyle program for metabolic syndrome-associated osteoarthritis: the "Plants for Joints" randomized controlled trial. Osteoarthritis Cartilage 2023; 31:1491-1500. [PMID: 37328047 DOI: 10.1016/j.joca.2023.05.014] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 05/04/2023] [Accepted: 05/04/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE To determine the effectiveness of the "Plants for Joints" multidisciplinary lifestyle program in patients with metabolic syndrome-associated osteoarthritis (MSOA). DESIGN Patients with hip or knee MSOA were randomized to the intervention or control group. The intervention group followed a 16-week program in addition to usual care based on a whole food plant-based diet, physical activity, and stress management. The control group received usual care. The patient-reported Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC) total score (range 0-96) was the primary outcome. Secondary outcomes included other patient-reported, anthropometric, and metabolic measures. An intention-to-treat analysis with a linear-mixed model adjusted for baseline values was used to analyze between-group differences. RESULTS Of the 66 people randomized, 64 completed the study. Participants (84% female) had a mean (SD) age of 63 (6) years and body mass index of 33 (5) kg/m2. After 16 weeks, the intervention group (n = 32) had a mean 11-point larger improvement in WOMAC-score (95% CI 6-16; p = 0.0001) compared to the control group. The intervention group also lost more weight (-5 kg), fat mass (-4 kg), and waist circumference (-6 cm) compared to the control group. Patient-Reported Outcomes Measurement Information System (PROMIS) fatigue, pain interference, C-reactive protein, hemoglobin A1c, fasting glucose, and low-density lipoproteins improved in the intervention versus the control group, while other PROMIS measures, blood pressure, high-density lipoproteins, and triglycerides did not differ significantly between the groups. CONCLUSION The "Plants for Joints" lifestyle program reduced stiffness, relieved pain, and improved physical function in people with hip or knee MSOA compared to usual care.
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Affiliation(s)
- Wendy Walrabenstein
- Reade Center for Rheumatology and Rehabilitation, Amsterdam, the Netherlands; Department of Clinical Immunology and Rheumatology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Rheumatology & immunology Center, Amsterdam, the Netherlands; Department of Nutrition and Dietetics, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands; Amsterdam Rehabilitation Research Center Reade, Amsterdam, the Netherlands.
| | - Carlijn A Wagenaar
- Reade Center for Rheumatology and Rehabilitation, Amsterdam, the Netherlands; Department of Clinical Immunology and Rheumatology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Rheumatology & immunology Center, Amsterdam, the Netherlands; Amsterdam Rehabilitation Research Center Reade, Amsterdam, the Netherlands
| | - Marieke van de Put
- Reade Center for Rheumatology and Rehabilitation, Amsterdam, the Netherlands; Amsterdam Rehabilitation Research Center Reade, Amsterdam, the Netherlands
| | - Marike van der Leeden
- Reade Center for Rheumatology and Rehabilitation, Amsterdam, the Netherlands; Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands; Amsterdam Movement Sciences Research Institute, Amsterdam, the Netherlands; Amsterdam Rehabilitation Research Center Reade, Amsterdam, the Netherlands
| | - Martijn Gerritsen
- Reade Center for Rheumatology and Rehabilitation, Amsterdam, the Netherlands; Amsterdam Rheumatology & immunology Center, Amsterdam, the Netherlands; Amsterdam Rehabilitation Research Center Reade, Amsterdam, the Netherlands
| | - Jos W R Twisk
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands; Amsterdam Rehabilitation Research Center Reade, Amsterdam, the Netherlands
| | - Martin van der Esch
- Reade Center for Rheumatology and Rehabilitation, Amsterdam, the Netherlands; Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Faculty of Health, Amsterdam, the Netherlands; Amsterdam Rehabilitation Research Center Reade, Amsterdam, the Netherlands
| | - Henriët van Middendorp
- Institute of Psychology, Health, Medical, & Neuropsychology Unit, Leiden University, Leiden, the Netherlands; Amsterdam Rehabilitation Research Center Reade, Amsterdam, the Netherlands
| | - Peter J M Weijs
- Department of Nutrition and Dietetics, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands; Amsterdam Movement Sciences Research Institute, Amsterdam, the Netherlands; Department of Nutrition & Dietetics, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands; Amsterdam Rehabilitation Research Center Reade, Amsterdam, the Netherlands
| | - Leo D Roorda
- Reade Center for Rheumatology and Rehabilitation, Amsterdam, the Netherlands; Amsterdam Rehabilitation Research Center Reade, Amsterdam, the Netherlands
| | - Dirkjan van Schaardenburg
- Reade Center for Rheumatology and Rehabilitation, Amsterdam, the Netherlands; Department of Clinical Immunology and Rheumatology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Rheumatology & immunology Center, Amsterdam, the Netherlands; Amsterdam Rehabilitation Research Center Reade, Amsterdam, the Netherlands
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14
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Ederer DJ, Lee SH, Belay B, Boutelle K, Park S. Associations between comfort eating and weight change during the COVID-19 pandemic among U.S. adults. Hum Nutr Metab 2023; 33:10.1016/j.hnm.2023.200212. [PMID: 38618183 PMCID: PMC11010443 DOI: 10.1016/j.hnm.2023.200212] [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] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
Objective To examine associations between comfort eating in response to loneliness or stress and weight change during the COVID-19 pandemic among U.S. adults. Design Quantitative, cross-sectional study. Setting The 2021 SummerStyles survey data. Subjects U.S. adults (≥18 years; N = 4068). Measures The outcome was reported weight changes since the start of the COVID-19 pandemic with four responses: lost weight, weight remained the same, gained weight, and don't know. The exposure variable was frequency of comfort eating in response to loneliness or stress during the past year with three responses: never/ rarely, sometimes, or often/always. Analysis We used chi-square analysis to examine the independence of survey variables related to weight changes, and comfort eating in response to loneliness or stress during the COVID-19 pandemic. Next, we used a multinomial logistic regression to estimate adjusted odds ratios for weight changes by comfort eating in response to loneliness or stress frequency. Results Overall, 20.1% of adults reported losing weight, 39.9% remained about the same weight, 30.4% gained weight, and 9.4% did not know about their weight change during the COVID-19 pandemic. Taking comfort by eating in response to loneliness or stress was reported by over 33% of participants (often/always = 8.3%; sometimes = 25.3%). Weight change and comfort eating during the COVID-19 pandemic significantly varied by sociodemographic factors. Respondents that sometimes or often/always reported taking comfort by eating in response to loneliness or stress were more likely to report losing weight (Adjusted Odds Ratio ranges: 1.62-2.99) or gaining weight (Adjusted Odds Ratio ranges: 3.10-4.61) than those who never/rarely took comfort by eating in response to loneliness or stress. Conclusions Taking comfort by eating when stressed/lonely was significantly associated with reported weight changes during the COVID-19 pandemic. Weight changes may lead to additional health complications. Implementing evidence-based strategies to reduce loneliness or stress and support healthy eating during the COVID-19 pandemic may benefit weight management and future well-being.
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Affiliation(s)
- David J. Ederer
- Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, Atlanta, GA 30341, USA
- Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Center for Surveillance, Epidemiology, and Laboratory Services, USA
| | - Seung Hee Lee
- Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, Atlanta, GA 30341, USA
| | - Brook Belay
- Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, Atlanta, GA 30341, USA
| | - Kerri Boutelle
- University of California San Diego, Department of Pediatrics, San Diego, CA, USA
| | - Sohyun Park
- Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, Atlanta, GA 30341, USA
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15
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Alruwaili TAM, Alshehri SAK, Thirunavukkarasu A, Elfarargy MS, Tariq Alanazi K, Muharib R. Alruwaili K, Alanezi YSA, Abdulhadi Alruwaili A. Assessment of health promotion behavior and associated factors among the northern Saudi adolescent population: a cross-sectional study. PeerJ 2023; 11:e15567. [PMID: 37397023 PMCID: PMC10312158 DOI: 10.7717/peerj.15567] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 05/24/2023] [Indexed: 07/04/2023] Open
Abstract
Background and Aim Health promotions among the adolescent population have a significant role in achieving the 2030 sustainable development goals of the World Health Organization. The COVID-19 pandemic has led to several devastating impacts on the health, economic, social, and healthcare systems, and adolescents' health promotions are no exception. We assessed health promotion behaviors and associated factors among the adolescent population of northern Saudi Arabia (KSA). Methods We used the Arabic version of the adolescent health promotion scale (AHPS-40) among the 400-adolescent population. The AHPS-40 assessed six domains of adolescent health behavior: nutrition, social support, health responsibility, life appreciation, exercise, and stress management. We applied the Chi-square test to identify the associated factors of adolescent health promotion activities and the logistic regression test to find the predictors for overall health promotion categories. Results Of the studied participants, the mean ± SD of the total AHPS-40 was 103.31 ± 18.78. The nutrition domain of the AHPS-40 was significantly associated with the age group (p = 0.002), and the social support domain was significantly related to fathers' (p = 0.022) and mothers' education (p = 0.006). The exercise domain of AHPS-40 was significantly associated with age group (p = 0.018) and school level (p = 0.026). Gender was significantly associated with most of the six domains. Furthermore, more than half (52.7%) of them had a low health promotion behavior, which was significantly associated with gender (adjusted odds ratio = 1.59, 95% CI of AOR = 1.04 -2.45, p = 0.032). Conclusion Our study results suggest improving health promotion behaviors by instituting awareness-raising and health promotion intervention programs for adolescent groups. Furthermore, we recommend a focused, exploratory, mixed-method survey among the adolescents of other regions of KSA to identify the region-specific adolescent's health promotion behaviors.
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Affiliation(s)
| | | | - Ashokkumar Thirunavukkarasu
- Department of Community and Family Medicine, College of Medicine, Jouf University, Sakaka, Aljouf, Saudi Arabia
| | - Mohamed Shawky Elfarargy
- Department of Pediatrics, College of Medicine, Jouf University, Sakaka, Aljouf, Saudi Arabia
- Department of Pediatrics, Faculty of Medicine, Tanta University, Gharbia Governorate, Egypt
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Kao TSA, Ling J, Alanazi M, Atwa A, Suriyawong W. Effects of mindfulness-based interventions on anthropometric outcomes: A systematic review and meta-analysis. Obes Res Clin Pract 2023:S1871-403X(23)00046-7. [PMID: 37211464 DOI: 10.1016/j.orcp.2023.05.006] [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] [Received: 02/28/2023] [Revised: 05/08/2023] [Accepted: 05/12/2023] [Indexed: 05/23/2023]
Abstract
BACKGROUND AND OBJECTIVES The effects of mindfulness-based interventions (MBIs) on anthropometrics remain obscure. This review quantitatively synthesizes the effects of MBIs on decreasing body mass index (BMI), waist circumference (WC), weight, and percent body fat (%BF). METHODS Seven databases, including CINAHL Plus with Full Text, PubMed, PsycINFO, Cochrane, Web of Science Core Collection, Embase, and Sociological Abstracts were searched; studies with a comparison group were selected. Random-effects models were then applied to estimate the pooled effects (Hedge's g), while exploratory moderation analyses with mixed-effects models were performed to explore potential moderators of MBIs on anthropometrics. RESULTS The pooled effect size was -0.36 (p < .001) on BMI, -0.52 (p < .001) on WC, -1.20 (p < .004) on weight loss, and -0.43 (p = .389) on %BF. The long-term effects from baseline to follow-up and from post-intervention to follow-up were sustained on BMI (-0.37, p = .027; -.24, p = .065) and weight loss (-1.91, p = .027; -0.74, p = .011) respectively. For weight loss, adding mindful movement had greater effects than those without (-2.65 vs -0.39, p < .001). CONCLUSION Our findings support the short-term MBI effects on BMI reduction, WC, weight, and %BF, and long-term effects on reducing BMI and weight. Future efforts should focus on sustaining effects on reducing WC and %BF.
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Affiliation(s)
| | - Jiying Ling
- College of Nursing, Michigan State University, East Lansing, MI, USA
| | - Mohammed Alanazi
- College of Nursing, Michigan State University, USA; University of Bisha, Bisha, Saudi Arabia
| | - Ahmed Atwa
- Department of Translational Neuroscience, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA; Neuroscience Program, Michigan State University, East Lansing, MI, USA
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da Silva CCG, Bolognani CV, Amorim FF, Imoto AM. Effectiveness of training programs based on mindfulness in reducing psychological distress and promoting well-being in medical students: a systematic review and meta-analysis. Syst Rev 2023; 12:79. [PMID: 37147732 PMCID: PMC10160720 DOI: 10.1186/s13643-023-02244-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 07/14/2021] [Accepted: 04/24/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND Medical schools have used mindfulness meditation as a strategy to assist students in stress management. This study aimed to seek evidence regarding the effectiveness of mindfulness-based training programs in reducing psychological distress and promoting the well-being of medical students. METHODS We conducted a systematic review and meta-analysis. Cochrane Library, Embase, PubMed/MEDLINE, PsycINFO/PsycNet, LILACS/BVS, ERIC (ProQuest), Web of Science, OpenGrey, and Google Scholar were searched for randomized clinical trials published until March 2022, without time or language restrictions. Two authors independently screened the articles, extracted data using a standardized extraction form, and assessed the methodological quality of the included studies using the Cochrane's Risk of Bias 2 (ROB 2) tool and the quality of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool. RESULTS Of the 848 articles retrieved, 8 met the inclusion criteria. Mindfulness-based training improved the outcomes: mindfulness (small post-intervention effect: SMD = 0.29; 95% CI: 0.03 to 0.54; p = 0.03; I2 = 46%; high evidence quality, and small effect at follow-up: SMD = 0.37; 95% CI: 0.04 to 0.70; p = 0.03; I2 = 53%; low evidence quality), psychological well-being/health (there was no statistically significant difference between the groups in the post-intervention effect: SMD = - 0.27; 95% CI: - 0.67 to 0.13; p = 0.18; I2 = 76%; moderate evidence quality, and a significant difference at follow-up: SMD = - 0.73; 95% CI: - 1.23 to - 0.23; p = 0.004; I2 = 61%; low evidence quality), and stress (small post-intervention effect: SMD = - 0.29; CI of 95%: - 0.56 to - 0.02; p = 0.04; I2 = 57%; moderate evidence quality, and moderate effect at follow-up: SMD = - 0.45, 95% CI: - 0.67 to - 0.22, p = 0.0001, I2 = 0%, moderate evidence quality). The quality of evidence for the anxiety, depression, and resilience outcomes is low and for the empathy outcome, very low. CONCLUSION The results indicate that the students who participated in the mindfulness training perceived improvements in the stress and psychological distress symptoms and improved health perception and psychological well-being. However, the significant heterogeneity among studies should be considered when interpreting these findings. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020153169.
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Affiliation(s)
- Claudia Cardoso Gomes da Silva
- Programa de Pós-Graduação em Ciências da Saúde, Coordenação de Cursos Pós-Graduação Stricto Sensu, Escola Superior de Ciências da Saúde (ESCS), Setor Médico Hospitalar Norte, Conjunto A, Bloco 01, Edifício Fepecs - Asa Norte, Brasília, DF, 70710-907, Brazil.
- Coordenação de Pesquisa e Comunicação Científica, Escola Superior de Ciências da Saúde (ESCS), Setor Médico Hospitalar Norte, Conjunto A, Bloco 01, Edifício Fepecs - Asa Norte, Brasília, DF, 70710-907, Brazil.
| | - Cláudia Vicari Bolognani
- Coordenação de Pesquisa e Comunicação Científica, Escola Superior de Ciências da Saúde (ESCS), Setor Médico Hospitalar Norte, Conjunto A, Bloco 01, Edifício Fepecs - Asa Norte, Brasília, DF, 70710-907, Brazil
| | - Fábio Ferreira Amorim
- Programa de Pós-Graduação em Ciências da Saúde, Coordenação de Cursos Pós-Graduação Stricto Sensu, Escola Superior de Ciências da Saúde (ESCS), Setor Médico Hospitalar Norte, Conjunto A, Bloco 01, Edifício Fepecs - Asa Norte, Brasília, DF, 70710-907, Brazil
| | - Aline Mizusaki Imoto
- Programa de Pós-Graduação em Ciências da Saúde, Coordenação de Cursos Pós-Graduação Stricto Sensu, Escola Superior de Ciências da Saúde (ESCS), Setor Médico Hospitalar Norte, Conjunto A, Bloco 01, Edifício Fepecs - Asa Norte, Brasília, DF, 70710-907, Brazil
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Valizadeh L, Zamanzadeh V, Namdar Areshtanab H, Avazeh M, Babaei N. Stress management protocol for nurses working in the COVID-19 wards. Heliyon 2023; 9:e15770. [PMID: 37124336 PMCID: PMC10125915 DOI: 10.1016/j.heliyon.2023.e15770] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 04/12/2023] [Accepted: 04/20/2023] [Indexed: 05/02/2023] Open
Abstract
Purpose Due to necessity of immediate support strategies for nurses during COVID-19 pandemic and lack of comprehensive and applied standard guidelines, the present study was conducted to develop stress management protocol for nurses working in COVID-19 wards with an approach based on the best scientific evidences. Methods This descriptive methodological and validation study was conducted with evidence-based approach based on Stetler model in two hospitals of Iran in 2020. In order to identify the resources of stress and the solutions provided to deal with it to design the protocol, a comprehensive literature review was performed. After extracting evidence, they were ranked based on the levels of evidence and designed as a protocol. Quality appraisal of guideline was done using AGREEII instrument by an expert panel. The applicability of the protocol was assessed by a group of nurses through focus group discussion. Results Out of 184 studies, 28 articles related to the topic were selected. According to the expert panel, in the AGREEII domains, Scope and Purpose (87.5%) and Applicability (70.5%) were the highest and the lowest scores respectively. The "Stress Management Protocol for Nurses Working in COVID-19 Wards" was designed in six sections, which was elaborated relative to each stress resources. Members of the focus group mostly considered the evidence-based recommendations feasible by making suggestions to some items. Conclusion This study emphasized the important role of proper planning by health care system officials according to the designed protocol to manage stress and increase the self-efficacy of nurses in critical situations.
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Affiliation(s)
- Leila Valizadeh
- Department of Pediatric Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vahid Zamanzadeh
- Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hossein Namdar Areshtanab
- Department of Psychiatric Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Marziyeh Avazeh
- Department of Pediatric Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nasib Babaei
- Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
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Goevaerts WF, Tenbült-van Limpt NCCW, Kop WJ, Birk MV, Liu Y, Brouwers RWM, Lu Y, Kemps HMC. Adherence to a lifestyle monitoring system in patients with heart disease: protocol for the care-on prospective observational trial. BMC Cardiovasc Disord 2023; 23:196. [PMID: 37069506 PMCID: PMC10111807 DOI: 10.1186/s12872-023-03222-x] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 04/01/2023] [Indexed: 04/19/2023] Open
Abstract
BACKGROUND Lifestyle factors such as physical fitness, dietary habits, mental stress, and sleep quality, are strong predictors of the occurrence, clinical course, and overall treatment outcomes of common cardiovascular diseases. However, these lifestyle factors are rarely monitored, nor used in daily clinical practice and personalized cardiac care. Moreover, non-adherence to long-term self-reporting of these lifestyle factors is common. In the present study, we evaluate adherence to a continuous unobtrusive and patient-friendly lifestyle monitoring system using evidence-based assessment tools. METHODS In a prospective observational trial (N = 100), the project investigates usability of and adherence to a monitoring system for multiple lifestyle factors relevant to cardiovascular disease, i.e., daily physical activity levels, dietary habits, mental stress, smoking, and sleep quality. Patients with coronary artery disease, valvular disease and arrhythmias undergoing an elective intervention are asked to participate. The monitoring system consists of a secured online platform with a custom-built conversational interface-a chatbot-and a wrist-worn wearable medical device. The wrist-worn device collects continuous objective data on physical activity and the chatbot is used to collect self-report data. Participants collect self-reported lifestyle data via the chatbot for a maximum of 4 days every other week; in the same week physiological data are collected for 7 days for 24 h. Data collection starts one week before the intervention and continues until 1-year after discharge. Via a dashboard, patients can observe their lifestyle measures and adherence to self-reporting, set and track personal goals, and share their lifestyle data with practitioners and relatives. The primary outcome of the trial is adherence to using the integrated platform for self-tracking data. The secondary outcomes include system usability, determinants of adherence and the relation between baseline lifestyle behaviour and long-term patient-relevant outcomes. DISCUSSION Systematic monitoring during daily life is essential to gain insights into patients' lifestyle behaviour. In this context, adherence to monitoring systems is critical for cardiologists and other care providers to monitor recovery after a cardiac intervention and to detect clinical deterioration. With this project, we will evaluate patients' adherence to lifestyle monitoring technology. This work contributes to the understanding of patient-centered data collection and interpretation, to enable personalized care after cardiac interventions in order to ultimately improve patient-relevant outcomes and reduce health care costs. TRIAL REGISTRATION Netherlands Trial Registry (NTR) NL9861. Registered 6th of November 2021.
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Affiliation(s)
- W F Goevaerts
- Industrial Design, Eindhoven University of Technology, Eindhoven, The Netherlands.
- Department of Cardiology, Máxima Medical Centre, Eindhoven/Veldhoven, The Netherlands.
| | - N C C W Tenbült-van Limpt
- Industrial Design, Eindhoven University of Technology, Eindhoven, The Netherlands
- Department of Cardiology, Máxima Medical Centre, Eindhoven/Veldhoven, The Netherlands
| | - W J Kop
- Department of Medical and Clinical Psychology, Center of Research on Psychological Disorders and Somatic Diseases, Tilburg University, Tilburg, the Netherlands
| | - M V Birk
- Industrial Design, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Y Liu
- Industrial Design, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - R W M Brouwers
- Industrial Design, Eindhoven University of Technology, Eindhoven, The Netherlands
- Department of Cardiology, Máxima Medical Centre, Eindhoven/Veldhoven, The Netherlands
| | - Y Lu
- Industrial Design, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - H M C Kemps
- Industrial Design, Eindhoven University of Technology, Eindhoven, The Netherlands
- Department of Cardiology, Máxima Medical Centre, Eindhoven/Veldhoven, The Netherlands
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20
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Murad H. Cultural stress: The undiagnosed epidemic of our time. J Integr Med 2023; 21:221-225. [PMID: 37100716 DOI: 10.1016/j.joim.2023.03.008] [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] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 01/06/2023] [Indexed: 04/28/2023]
Abstract
Global technologies that have made the world more interconnected have also, inadvertently, amplified the forces of stress that are now with us 24 hours a day, seven days a week. The accumulated impact of this stress I call cultural stress anxiety syndrome and call on integrative medicine practitioners to recognize that it is exacerbating whatever acute stressors are also present in our patients' lives. In this Commentary, I outline seven major components of cultural stress (time pressure, digital intrusion, digital dependency, isolation, sedentary lifestyle, poor sleep, and uncertainty), describe their health consequences, and finally, offer cultural stress-specific remedies I have utilized in my own practice, along with studies that affirm their efficacy. My hope is that we, as integrative medicine practitioners who are cognizant of the role that stress plays in disease development, will more fully appreciate the added impact of cultural stress, and advise our patients on the importance of proactive stress management. Please cite this article as: Murad H. Cultural stress: the undiagnosed epidemic of our time. J Integr Med. 2023; Epub ahead of print.
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Affiliation(s)
- Howard Murad
- Inclusive Health Medical Group, Los Angeles, CA 90245, USA.
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21
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Zisopoulou T, Varvogli L. Stress Management Methods in Children and Adolescents: Past, Present, and Future. Horm Res Paediatr 2023; 96:97-107. [PMID: 36096110 DOI: 10.1159/000526946] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 09/27/2021] [Accepted: 06/21/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Stress is a natural automatic reaction of organisms to challenging or threatening stimuli. Prevalence rates reveal an increasing number of students both in elementary and secondary education suffering from anxiety and other stress-related disorders and illnesses [The Journal of Pediatrics. 2009 Mar;154(3):322-6]. Literature shows a plethora of stress management techniques being used with children and adults to achieve stress reduction and inner peace. This narrative review primarily aimed at summarizing evidence-based relaxation techniques currently used by minors, contrasting them with data from the past and directions for the future. *(Additional content can be found at the bottom page of this review). SUMMARY Literature research revealed a plethora of stress management techniques, including breathing practices or exercises, meditation, guided imagery, clinical hypnosis, cognitive behavioral therapy, behavioral therapy, third wave therapies, interpersonal therapies, progressive muscle relaxation, autogenic training, biofeedback training, and mindfulness, that are deemed to be effective to treat stress and a variety of stress-related disorders such as anxiety disorders, depression, post-traumatic stress disorder, obsessive-compulsive disorder (OCD), headaches, abdominal pain, perioperative anxiety and postoperative pain, cancer, and attention-deficit hyperactivity disorder. These evidence-based stress management techniques have been successfully employed in various settings such as schools, waiting rooms, dental offices, or inpatient settings. KEY MESSAGES Stress management techniques used by children and adolescents are important to reduce anxiety, stress, and depressive symptoms, improve social skills, reduce stress-related physical pain, and achieve academic improvement across settings and diagnoses.
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Affiliation(s)
- Triantafyllia Zisopoulou
- Stress Science and Health Promotion Post Graduate Program, National and Kapodestrian University of Athens Medical School, Athens, Greece
| | - Liza Varvogli
- Stress Science and Health Promotion Post Graduate Program, National and Kapodestrian University of Athens Medical School, Athens, Greece
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Stratton E, Player MJ, Glozier N. Online mental health training program for male-dominated organisations: a pre-post pilot study assessing feasibility, usability, and preliminary effectiveness. Int Arch Occup Environ Health 2023; 96:641-649. [PMID: 36800032 DOI: 10.1007/s00420-023-01961-0] [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] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 02/09/2023] [Indexed: 02/18/2023]
Abstract
PURPOSE The emergence of digital health interventions for mental ill-health in the workplace is expansive. Digital interventions delivered in male-dominated settings are less so. This pilot study aimed to assess the usability, feasibility, acceptability, and preliminary effects of an online intervention in a male-dominated organization. We focus on male-dominated as mental ill-health is frequently unrecognized and underdiagnosed among males. METHODS Unwind, a 7-week internet-based program with stress-management components, was tested in a pre-post pilot study. Unwind gets users to identify and understand their stress triggers and assists them to develop adaptive ways to manage these and their stress. Participants were Australian adults employed in a mining company. Follow-up assessment occurred 8 weeks after baseline. The primary outcome measure was change in stress symptoms, with secondary outcomes; change in depression, anxiety, insomnia, well-being, and alcohol use. User feedback and program data were analyzed to assess usability, engagement, and intervention adherence. RESULTS Eligible participants n = 87 showed significant reductions in stress (g = 0.46, p < 0.001), depression (g = 0.47, p < 0.001), anxiety (g = 0.50, p < 0.001), insomnia (g = 0.44, p < 0.001), and well-being (g = 0.32, p = 0.004) post-intervention. Significant improvements were observed in both well and unwell (mental ill-health) and male and female participants. There was no gender effect on outcomes. A dose-response was observed as the number of modules used was related positively to improvement in anxiety (F1,86 = 5.735, p = 0.019; R2 = 0.25). Overall users rated Unwind as useful and engaging. CONCLUSION This study presents evidence base that Unwind is a feasible and acceptable approach to reducing employees' mental health-related symptoms in typically difficult-to-reach male-dominated industries. Unwind is feasible for larger scale delivery within male-dominated industries.
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Affiliation(s)
- Elizabeth Stratton
- Central Clinical School, Faculty of Medicine and Health, University of Sydney, Office 8, Lvl 5, Professor Marie Bashir Building, Missenden Road, Camperdown, NSW, 2006, Australia. .,ARC Centre of Excellence for Children and Families Over the Life Course, University of Sydney, Office 8, Lvl 5, Professor Marie Bashir Building, Missenden Road, Camperdown, NSW, 2006, Australia.
| | - Michael J Player
- Central Clinical School, Faculty of Medicine and Health, University of Sydney, Office 8, Lvl 5, Professor Marie Bashir Building, Missenden Road, Camperdown, NSW, 2006, Australia
| | - Nick Glozier
- Central Clinical School, Faculty of Medicine and Health, University of Sydney, Office 8, Lvl 5, Professor Marie Bashir Building, Missenden Road, Camperdown, NSW, 2006, Australia.,ARC Centre of Excellence for Children and Families Over the Life Course, University of Sydney, Office 8, Lvl 5, Professor Marie Bashir Building, Missenden Road, Camperdown, NSW, 2006, Australia
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Sharif Nia H, Hosseini L, Ashghali Farahani M, Froelicher ES. Development and validation of care stress management scale in family caregivers for people with Alzheimer: a sequential-exploratory mixed-method study. BMC Geriatr 2023; 23:82. [PMID: 36750799 DOI: 10.1186/s12877-023-03785-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 01/30/2023] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND Caring for a person with Alzheimer's disease is stressful for caregivers. So that, considering all the emotional and financial costs imposed on the families of Alzheimer's patients, stress from caring is an issue that cannot be ignored and plans need to be developed to help these caregivers to manage the care properly. The current study was designed to develop a valid and reliable care stress management scale for family caregivers of patients with Alzheimer's. METHODS This study is a methodological study with a sequential-exploratory mixed-method approach that was performed in two-phase: develop the caring stress management scale and evaluate the psychometric properties of the scale. In the first phase, 14 semi-structured face-to-face interviews were performed with family caregivers of patients with Alzheimer's. The interviews were transcribed immediately and an item pool with 275 items was prepared. After removing the duplicate or overlapping code, the initial format of the caring stress management scale (CSMS) was designed. In the second step, the items of the CSMS were evaluated using face and content validity. After that, the construct validity was evaluated using exploratory factor analysis, confirmatory factor analysis, and convergent and divergent validity respectively. Finally, the reliability was assessed by stability and internal consistency. The sample size was 435 and data was gathered via an online form questionnaire. RESULTS This study designed the CSMS with two factors including emotional-focused coping (4 items) and problem-focused coping (4 items) that explained 51.00% of the total variance. The results of the confirmatory factor analysis showed a good model fit. Furthermore, the internal consistency and stability of this scale were acceptable. CONCLUSION The results showed that the care stress management scale has two factors in Iranian family caregivers and it is valid and reliable and can be used by therapists and researchers.
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Riches S, Jeyarajaguru P, Taylor L, Fialho C, Little J, Ahmed L, O’Brien A, van Driel C, Veling W, Valmaggia L. Virtual reality relaxation for people with mental health conditions: a systematic review. Soc Psychiatry Psychiatr Epidemiol 2023:10.1007/s00127-022-02417-5. [PMID: 36658261 PMCID: PMC9852806 DOI: 10.1007/s00127-022-02417-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 12/21/2022] [Indexed: 01/21/2023]
Abstract
PURPOSE Vulnerability to stress is linked to poor mental health. Stress management interventions for people with mental health conditions are numerous but they are difficult to implement and have limited effectiveness in this population. Virtual reality (VR) relaxation is an innovative intervention that aims to reduce stress. This review aimed to synthesize evidence of VR relaxation for people with mental health conditions (PROSPERO 269405). METHODS Embase, Medline, PsycInfo, and Web of Science were searched until 17th September 2021. The review was carried out according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The Effective Public Health Practice Project (EPHPP) tool assessed methodological quality of studies. RESULTS Searching identified 4550 studies. Eighteen studies (N = 848) were included in the review. Studies were published between 2008 and 2021. Eleven were conducted in Europe. Thirteen studies were controlled trials. Participants were mostly working-age adult outpatients experiencing anxiety or stress-related conditions. Other conditions included eating disorders, depression, bipolar disorder, and psychosis. Five studies tested inpatients. All studies used a range of nature-based virtual environments, such as forests, islands, mountains, lakes, waterfalls, and most commonly, beaches to promote relaxation. Studies provided evidence of the feasibility, acceptability, and short-term effectiveness of VR relaxation to increase relaxation and reduce stress. EPHPP ratings were 'strong' (N = 11), 'moderate' (N = 4), and 'weak' (N = 3). CONCLUSIONS VR relaxation has potential as a low-intensity intervention to promote relaxation and reduce stress for adults with mental health conditions, especially anxiety and stress-related problems. Further research is warranted on this promising intervention.
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Affiliation(s)
- Simon Riches
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, SE5 8AF, UK. .,Social Genetic and Developmental Psychiatry Centre, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, SE5 8AF, UK. .,South London and Maudsley NHS Foundation Trust, London, BR3 3BX, UK.
| | - Priyanga Jeyarajaguru
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, SE5 8AF UK
| | - Lawson Taylor
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, SE5 8AF UK
| | - Carolina Fialho
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, SE5 8AF UK
| | - Jordan Little
- South London and Maudsley NHS Foundation Trust, London, BR3 3BX UK
| | - Lava Ahmed
- South London and Maudsley NHS Foundation Trust, London, BR3 3BX UK
| | | | - Catheleine van Driel
- University Center for Psychiatry, University of Groningen, University Medical Center Groningen, PO Box 30.001 (HPC CC60), 9700 RB Groningen, The Netherlands
| | - Wim Veling
- University Center for Psychiatry, University of Groningen, University Medical Center Groningen, PO Box 30.001 (HPC CC60), 9700 RB Groningen, The Netherlands
| | - Lucia Valmaggia
- Department of Psychology, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, SE5 8AF UK ,South London and Maudsley NHS Foundation Trust, London, BR3 3BX UK
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Shamsdanesh S, Nourizadeh R, Hakimi S, Ranjbar F, Mehrabi E. The effect of counseling with stress management approach on postpartum anxiety and distress and breastfeeding self-efficacy during COVID-19 pandemic: a ramdomized controlled trial. BMC Pregnancy Childbirth 2023; 23:26. [PMID: 36639738 DOI: 10.1186/s12884-023-05356-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 01/06/2023] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Successful breastfeeding is related to the psychosocial conditions of the mother. Covid19 pandemic resulted in psychological consequences in women during postpartum period. Maternal anxiety and distress reduce the chances of exclusive breastfeeding. The present study aimed to investigate the effect of counseling with stress management approach on postpartum anxiety and distress and breastfeeding self-efficacy (BSE) during COVID-19 pandemic. METHOD This randomized controlled clinical trial was conducted on 64 breastfeeding mothers referred to health care centers in Tabriz, Iran in 2021. Participants were assigned into the intervention and control groups in a ratio of 1: 1 using block randomization in a block size of 4 and 6. The intervention group participated in six individual 60-90 min sessions. Spielberger State-Trait Anxiety Inventory (STAI), postpartum distress (PMD), and BSE questionnaires were completed before and 4-week after the intervention by the control and intervention groups. Independent t-test and ANCOVA were used to compare the outcomes between two groups. RESULTS According to the ANCOVA results by controlling the baseline values and after the intervention, the mean score of anxiety in the intervention group was lower than that in the control group [Adjusted Mean Difference (AMD): -13.82, 95%, confidence interval (CI): -12.35 to -15.29, (p < 0.001)]. Further, the mean score of postpartum distress after intervention was lower in the intervention group compared with that in the control group [AMD:5.31 95% CI: -3.00 to -7.37 (p < 0.001)]. After the intervention, the mean score of BSE in the intervention group was significantly higher than that in the control group [AMD: 25.57, 95% CI: 22.85 to 28.29 (p < 0.001)]. CONCLUSION Stress management counseling can improve postpartum anxiety and distress and BSE and increase breastfeeding. However, more studies are needed for a definitive conclusion. TRIAL REGISTRATION Iranian Registry of Clinical Trials (IRCT): IRCT20171007036615N6. Date of registration: 15/09/2021.
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Wang Q, Collet JP, Mei J, Chen G, Huang S, Yang Y, Wang W, Ding F. Complex interactive multimodal intervention to improve personalized stress management among healthcare workers in China: A knowledge translation protocol. Digit Health 2023; 9:20552076231184052. [PMID: 37545629 PMCID: PMC10399255 DOI: 10.1177/20552076231184052] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 06/07/2023] [Indexed: 08/08/2023] Open
Abstract
Objectives Numerous stress management interventions have been implemented in the workplace, but few are adapted to the healthcare setting. Due to the nature of their jobs, healthcare workers (HCWs) may find it difficult to adopt recommended stress management strategies. We present the protocol for a 12-week personalized stress management intervention among HCWs to change their behavior as well as improve physiological/psychological outcomes. Methods It is a pragmatic quasi-experimental study involving stressed HCWs from two general hospitals in Wuhan, China. The intervention group will receive a complex interactive multimodal intervention, including advanced education via mobile connection, participation in a web-based social network, tailored feedback, and the support of a nurse coach, while the control group will engage in self-guided stress management. Results The primary outcome is centered on behavioral measures, namely improvements in stress management practice frequency after a 12-week intervention. The secondary outcomes are the changes in stress-related physiological indices (i.e. high frequency variability and normalized unit assessed by Holter) and psychological indicators (scores on the Perceived Stress Scale and Depression, Anxiety, Stress Scale) following 12 weeks of treatment. Conclusion The knowledge translation intervention builds on a body of work defining the role of individualized instruction and feedback intervention, as well as group intervention through WeChat social network and personalized coaching. We believe this novel intervention will help HCWs promote their stress management awareness and skills, and ultimately benefit their long-term health. Trial Registration ClinicalTrials.gov., NCT05239065. Registered 14 February 2022-Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT05239065.
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Affiliation(s)
- Quan Wang
- Department of Pharmacology, School of Basic Medical Sciences, Fudan University, Shanghai, China
- Nursing College, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jean-Paul Collet
- UBC Department of Pediatrics and Children's Hospital Research Institute, Vancouver, Canada
| | - Junhua Mei
- Department of Neurology, The First Hospital of Wuhan City, Wuhan, China
| | - Guohua Chen
- Department of Neurology, The First Hospital of Wuhan City, Wuhan, China
| | - Sufang Huang
- Nursing College, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuan Yang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wei Wang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fengfei Ding
- Department of Pharmacology, School of Basic Medical Sciences, Fudan University, Shanghai, China
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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O'Donnell MB, Scott SR, Ellisor BM, Cao VT, Zhou C, Bradford MC, Pihoker C, DeSalvo DJ, Malik FS, Hilliard ME, Rosenberg AR, Yi-Frazier JP. Protocol for the Promoting Resilience in Stress Management (PRISM) intervention: A multi-site randomized controlled trial for adolescents with type 1 diabetes. Contemp Clin Trials 2023; 124:107017. [PMID: 36410689 PMCID: PMC9839528 DOI: 10.1016/j.cct.2022.107017] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 11/14/2022] [Accepted: 11/16/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Adolescents with type 1 diabetes (T1D) are at high risk for elevated diabetes distress, which greatly impacts diabetes management, glycemic outcomes and overall quality of life. Developing protective skills and "resilience resources" to navigate adversity and manage diabetes distress has high potential to help adolescents with T1D achieve optimal behavioral, psychological, and health outcomes. The "Promoting Resilience in Stress Management" (PRISM) program is a manualized, brief, skills-based intervention delivered over 6 months via two 45-60 min one-on-one sessions and a family meeting with a PRISM coach, and supplemented by booster calls and a digital app. This trial (PRISM versus usual care)is designed to:: (1) assess PRISM's impact on glycemic outcomes and diabetes distress among adolescents with T1D, and (2) explor PRISM's impact on resilience, self-reported adherence, and quality of life. METHODS We describe the protocol for a multi-site randomized controlled trial designed for adolescents ages 13-18 with elevated diabetes distress. The primary trial outcomes are glycemic outcomes and diabetes distress 6 months post-randomization. Secondary outcomes include resilience, self-reported adherence, and QOL 6 months post-randomization. Our hypothesis is that youth in the PRISM group will demonstrate better glycemic outcomes and improved diabetes distress, adherence, resilience, and QOL compared to usual care. CONCLUSIONS This study will provide methodologically rigorous data and evidence regarding a novel intervention to promote resilience among adolescents with T1D and elevated diabetes distress. This research has the potential to offer a practical, skills-based curriculum designed to improve outcomes for this high-risk group. TRIAL REGISTRATION Prospectively registered at Clinicaltrials.gov (NCT03847194).
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Affiliation(s)
- Maeve B O'Donnell
- Palliative Care and Resilience Lab, Seattle Children's Research Institute, Center for Clinical & Translational Research, Seattle, WA, United States of America; University of Washington School of Medicine, Department of Pediatrics, Division of Diabetes/Endocrinology, Seattle, WA, United States of America; Cambia Palliative Care Center of Excellence, University of Washington School of Medicine, Seattle, WA, United States of America
| | - Samantha R Scott
- Palliative Care and Resilience Lab, Seattle Children's Research Institute, Center for Clinical & Translational Research, Seattle, WA, United States of America; Department of Psychology, University of Denver, Denver, CO, United States of America
| | - Britney M Ellisor
- Palliative Care and Resilience Lab, Seattle Children's Research Institute, Center for Clinical & Translational Research, Seattle, WA, United States of America
| | - Viena T Cao
- Texas Children's Hospital and Baylor College of Medicine, Department of Pediatrics, Houston, TX, United States of America
| | - Chuan Zhou
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, WA, United States of America; University of Washington, School of Medicine, Department of Pediatrics, Division of General Pediatrics, Seattle, WA, United States of America
| | - Miranda C Bradford
- Core for Biostatistics, Epidemiology and Analytics for Research (BEAR) Core, Seattle Children's Research Institute, Seattle, WA, United States of America
| | - Catherine Pihoker
- University of Washington School of Medicine, Department of Pediatrics, Division of Diabetes/Endocrinology, Seattle, WA, United States of America
| | - Daniel J DeSalvo
- Texas Children's Hospital and Baylor College of Medicine, Department of Pediatrics, Houston, TX, United States of America
| | - Faisal S Malik
- University of Washington School of Medicine, Department of Pediatrics, Division of Diabetes/Endocrinology, Seattle, WA, United States of America; Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, WA, United States of America
| | - Marisa E Hilliard
- Texas Children's Hospital and Baylor College of Medicine, Department of Pediatrics, Houston, TX, United States of America
| | - Abby R Rosenberg
- Palliative Care and Resilience Lab, Seattle Children's Research Institute, Center for Clinical & Translational Research, Seattle, WA, United States of America; Cambia Palliative Care Center of Excellence, University of Washington School of Medicine, Seattle, WA, United States of America
| | - Joyce P Yi-Frazier
- Palliative Care and Resilience Lab, Seattle Children's Research Institute, Center for Clinical & Translational Research, Seattle, WA, United States of America.
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Lester EG, Fishbein NS, Peterson A, Vranceanu AM. Early feasibility testing of a web-based mind-body resiliency program for adults with neurofibromatosis: The NF-Web study. PEC Innov 2022; 1:100076. [PMID: 37213775 PMCID: PMC10194129 DOI: 10.1016/j.pecinn.2022.100076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 07/30/2022] [Accepted: 08/18/2022] [Indexed: 05/23/2023]
Abstract
Objectives We aimed to test early feasibility, acceptability, and signals of improvement after the 8-week individually delivered asynchronous, web-based mind-body program (NF-Web) modeled after the synchronous group-based live video program (Relaxation Response Resiliency Program for NF; 3RP-NF). Methods Two cohorts (cohort 1 n = 14, cohort 2 n = 14) completed baseline and posttest (feasibility markers, t-tests). Results Enrolled participants (N = 28; 80% of those eligible) completed baseline (N = 28; 100% of sample) and posttests (N = 25; 89.3%). Video lesson (58.0%) and homework (70.9%) completion were fair to good. Satisfaction (M = 8.85/10; SD = 2.35), credibility (M = 7.07/10; SD = 1.44), and expectancy (M = 6.68/10; SD = 2.10) were good to excellent. Participation was associated with statistically significant pre-to-post positive changes in quality of life (QoL; Physical, Psychological, Social, and Environmental,; p < 0.05) and emotional distress (depression, anxiety, and stress; p < 0.05). Pain intensity and interference did not improve significantly (p > 0.05) after participation. Conclusions NF-Web demonstrates initial feasibility, acceptability, and signals of improvement. Results support future trials to ascertain efficacy. Innovation Web-based programs may be valuable for individuals with rare illness who prefer to learn skills on their own timeline, have barriers to live video participation, and who also have apprehensions about interacting with others during treatment.
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Affiliation(s)
- Ethan G. Lester
- The Center for Health Outcomes and Interdisciplinary Research (CHOIR), Massachusetts General Hospital, Boston, MA, United States of America
- Harvard Medical School, Boston, MA, United States of America
- Corresponding author at: The Center for Health Outcomes and Interdisciplinary Research (CHOIR), Massachusetts General Hospital, Harvard Medical School, One Bowdoin Square, Suite 100, Boston, MA 02114, United States of America.
| | - Nathan S. Fishbein
- The Center for Health Outcomes and Interdisciplinary Research (CHOIR), Massachusetts General Hospital, Boston, MA, United States of America
| | - Annabel Peterson
- The Center for Health Outcomes and Interdisciplinary Research (CHOIR), Massachusetts General Hospital, Boston, MA, United States of America
| | - Ana-Maria Vranceanu
- The Center for Health Outcomes and Interdisciplinary Research (CHOIR), Massachusetts General Hospital, Boston, MA, United States of America
- Harvard Medical School, Boston, MA, United States of America
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Tjønnås MS, Guzmán-García C, Sánchez-González P, Gómez EJ, Oropesa I, Våpenstad C. Stress in surgical educational environments: a systematic review. BMC Med Educ 2022; 22:791. [PMID: 36380334 PMCID: PMC9667591 DOI: 10.1186/s12909-022-03841-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 10/29/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The effects of stress on surgical residents and how stress management training can prepare residents to effectively manage stressful situations is a relevant topic. This systematic review aimed to analyze the literature regarding (1) the current stress monitoring tools and their use in surgical environments, (2) the current methods in surgical stress management training, and (3) how stress affects surgical performance. METHODS A search strategy was implemented to retrieve relevant articles from Web of Science, Scopus, and PubMed. The 787 initially retrieved articles were reviewed for further evaluation according to the inclusion/exclusion criteria (Prospero registration number CRD42021252682). RESULTS Sixty-one articles were included in the review. The stress monitoring methods found in the articles showed heart rate analysis as the most used monitoring tool for physiological parameters while the STAI-6 scale was preferred for psychological parameters. The stress management methods found in the articles were mental-, simulation- and feedback-based training, with the mental-based training showing clear positive effects on participants. The studies analyzing the effects of stress on surgical performance showed both negative and positive effects on technical and non-technical performance. CONCLUSIONS The impact of stress responses presents an important factor in surgical environments, affecting residents' training and performance. This study identified the main methods used for monitoring stress parameters in surgical educational environments. The applied surgical stress management training methods were diverse and demonstrated positive effects on surgeons' stress levels and performance. There were negative and positive effects of stress on surgical performance, although a collective pattern on their effects was not clear.
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Affiliation(s)
- Maria Suong Tjønnås
- Department of Neuromedicine and Movement Science (INB), Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology, N-7491, Trondheim, Norway.
- SINTEF Digital, Health Department, Trondheim, Norway.
| | - Carmen Guzmán-García
- Biomedical Engineering and Telemedicine Centre (GBT), ETSI Telecomunicación, Center for Biomedical Technology, Universidad Politécnica de Madrid (UPM), Madrid, Spain
| | - Patricia Sánchez-González
- Biomedical Engineering and Telemedicine Centre (GBT), ETSI Telecomunicación, Center for Biomedical Technology, Universidad Politécnica de Madrid (UPM), Madrid, Spain
- Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
| | - Enrique Javier Gómez
- Biomedical Engineering and Telemedicine Centre (GBT), ETSI Telecomunicación, Center for Biomedical Technology, Universidad Politécnica de Madrid (UPM), Madrid, Spain
- Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
| | - Ignacio Oropesa
- Biomedical Engineering and Telemedicine Centre (GBT), ETSI Telecomunicación, Center for Biomedical Technology, Universidad Politécnica de Madrid (UPM), Madrid, Spain
| | - Cecilie Våpenstad
- SINTEF Digital, Health Department, Trondheim, Norway
- Department of Clinical and Molecular Medicine (IKOM), Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
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Plante TG. Principles for Managing Burnout among Catholic Church Professionals. Pastoral Psychol 2022; 72:23-31. [PMID: 36408424 PMCID: PMC9652599 DOI: 10.1007/s11089-022-01039-7] [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] [Subscribe] [Scholar Register] [Accepted: 09/07/2022] [Indexed: 06/16/2023]
Abstract
While a large body of research literature has explored the assessment, treatment, and prevention of worker burnout, much less research has focused on the unique issues associated with burnout in religious organizations, especially within the Roman Catholic Church. Catholic Church employees, whether clerics or laypersons, are embedded within a 2,000-year-old global hierarchical structure and organization that is unique in that it includes clerics with vows of chastity, obedience, and often poverty as well as ongoing crises related to clerical sexual abuse scandals, significant financial stressors, and a faith tradition that often overvalues sacrifice and suffering. The purpose of this brief article is to highlight burnout issues among Roman Catholic Church employees and offer principles and strategies for recognizing, treating, and avoiding burnout among these professionals. Five key principles for burnout management as well as several case examples are also presented.
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Affiliation(s)
- Thomas G. Plante
- Department of Psychology, Santa Clara University, Santa Clara, CA 95053-0333 USA
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, CA Stanford, USA
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Jung SJ, Lee SO, Choi MJ, Heo J, Chae SW, Cho BH. Influence of Comprehensive Lifestyle Intervention (LSI) Program on Health, Fatigue, and Quality of Life in Middle-Aged Women. J Lifestyle Med 2022; 12:127-137. [PMID: 36628179 PMCID: PMC9798878 DOI: 10.15280/jlm.2022.12.3.127] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 08/29/2022] [Indexed: 12/24/2022] Open
Abstract
Background Middle age is one of the most important times in a woman's life, and it is a time when multiple changes occur that affect the body and health. The study aimed to investigate the efficacy of a comprehensive lifestyle intervention (LSI) program, including stress management, on middle-aged women's physical, physiological, and mental health. Methods A total of 40 middle-aged women participated in a short-term LSI program, nutrition, exercise, and mental and physical management with various experiential activities. Physical measurements, biochemical indicators, stress hormones, chronic fatigue, and quality of life indicators were evaluated to interpret the clinical efficacy of the program. Results LSI program significantly improved satisfaction and quality of life in participants. Total chronic fatigue scores reduced significantly compared to scores before the start of the program. Moreover, fat mass and body fat were reduced without loss of muscle mass. Further, blood pressure and triglyceride levels significantly decreased after completing the LSI program. However, changes in stress hormone levels remained insignificant. Conclusion Adoption of LSI in middle-aged women demonstrated positive implications of the program. LSI efficiently regulates body fat, fat mass, fatigue, hypertension, and triglyceride levels which play a critical role in determining the quality of life. Thus, the LSI program could spread healthy lifestyles among middle-aged women.
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Affiliation(s)
- Su-Jin Jung
- Clinical Trial Center for Functional Foods (CTCF2), Jeonju, Korea,Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea
| | - Seung-Ok Lee
- Clinical Trial Center for Functional Foods (CTCF2), Jeonju, Korea,Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea,Division of Gastroenterology and Hepatology, Department of Internal Medicine, Jeonbuk National University Medical School, Jeonju, Korea
| | - Min-Jun Choi
- Clinical Trial Center for Functional Foods (CTCF2), Jeonju, Korea
| | - Jun Heo
- Jinangun Medical Center, Jinan, Korea
| | - Soo-Wan Chae
- Clinical Trial Center for Functional Foods (CTCF2), Jeonju, Korea,Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea,Corresponding author: Soo-Wan Chae, Clinical Trial Center for Functional Foods (CTCF2), Jeonbuk National University Hospital, 20 Geonjiro, Deokjin-gu, Jeonju, Jeollabuk-do, 54896, Republic of KoreaTel: 82-63-259-3040, Fax: 82-63-259-3060, E-mail:
| | - Baik-Hwan Cho
- Jinangun Medical Center, Jinan, Korea,Corresponding author: Baik-Hwan Cho, Jinangun Medical Center, 11145 Jinmu-ro, Jinan, Jeollabuk-do, 55422, Republic of KoreaTel: 82-63-430-7100, Fax: 82-63-430-7002, E-mail:
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Bautista RED, Smith FL, Celso BG. Enhancing the wellness of caregivers of individuals with epilepsy: The effects of a brief stress management course. Epilepsy Behav 2022; 133:108745. [PMID: 35716427 DOI: 10.1016/j.yebeh.2022.108745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 05/11/2022] [Accepted: 05/12/2022] [Indexed: 11/23/2022]
Abstract
PURPOSE To determine whether a brief stress management video can improve the quality of life of caregivers of persons with epilepsy (PWE). METHODS Thirty-three adult caregivers of PWE who scored 5 or higher on the Caregiver Self-Assessment Questionnaire (CSAQ) completed a 30-min stress management video. This was preceded by a pre-intervention assessment, followed by post-intervention assessment at 1 month, and a delayed post-intervention assessment evaluation 3 months after video was viewed. Measures of program acceptability were also obtained. RESULTS There was significant improvement when comparing pre- and post-intervention CSAQ scores. This improvement was sustained at 3 months post intervention. Measures of program acceptability were favorable. CONCLUSION A brief stress management course can help improve the quality of life of caregivers of PWE.
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Castellano GS, Tarasenko YN. An on-line mindfulness-based stress reduction program for health workers in Uruguay amidst the COVID-19 pandemic April 2020. Psychiatry Res 2022; 313:114599. [PMID: 35526423 PMCID: PMC9071193 DOI: 10.1016/j.psychres.2022.114599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 04/25/2022] [Accepted: 04/30/2022] [Indexed: 11/05/2022]
Affiliation(s)
- Graciela S. Castellano
- Departamento de Medicina Preventiva y Social, Facultad de Medicina, Universidad de la República, Av. Alfredo Navarro s/n, Montevideo, Uruguay,Jiann-Ping Hsu College of Public Health, Georgia Southern University, 501 Forest Drive Office 2012, Statesboro 30458, Georgia,Corresponding author at: Departamento de Medicina Preventiva y Social, Facultad de Medicina, Universidad de la República, Av. Alfredo Navarro s/n, Montevideo, Uruguay
| | - Yelena N. Tarasenko
- Departamento de Medicina Preventiva y Social, Facultad de Medicina, Universidad de la República, Av. Alfredo Navarro s/n, Montevideo, Uruguay,Jiann-Ping Hsu College of Public Health, Georgia Southern University, 501 Forest Drive Office 2012, Statesboro 30458, Georgia
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Hinwood M, Ilicic M, Gyawali P, Coupland K, Kluge MG, Smith A, Bowden S, Nilsson M, Walker FR. Psychological Stress Management and Stress Reduction Strategies for Stroke Survivors: A Scoping Review. Ann Behav Med 2022; 57:111-130. [PMID: 35689664 PMCID: PMC9899067 DOI: 10.1093/abm/kaac002] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Stroke can be a life-changing event, with survivors frequently experiencing some level of disability, reduced independence, and an abrupt lifestyle change. Not surprisingly, many stroke survivors report elevated levels of stress during the recovery process, which has been associated with worse outcomes. PURPOSE Given the multiple roles of stress in the etiology of stroke recovery outcomes, we aimed to scope the existing literature on stress management interventions that have been trialed in stroke survivors. METHODS We performed a database search for intervention studies conducted in stroke survivors which reported the effects on stress, resilience, or coping outcome. Medline (OVID), Embase (OVID), CINAHL (EBSCO), Cochrane Library, and PsycInfo (OVID) were searched from database inception until March 11, 2019, and updated on September 1, 2020. RESULTS Twenty-four studies met the inclusion criteria. There was significant variation in the range of trialed interventions, as well as the outcome measures used to assess stress. Overall, just over half (13/24) of the included studies reported a benefit in terms of stress reduction. Acceptability and feasibility were considered in 71% (17/24) and costs were considered in 17% (4/24) of studies. The management of stress was rarely linked to the prevention of symptoms of stress-related disorders. The overall evidence base of included studies is weak. However, an increase in the number of studies over time suggests a growing interest in this subject. CONCLUSIONS Further research is required to identify optimum stress management interventions in stroke survivors, including whether the management of stress can ameliorate the negative impacts of stress on health.
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Affiliation(s)
| | - Marina Ilicic
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia,School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW, Australia,Priority Research Centre for Stroke and Brain Injury, The University of Newcastle, Callaghan, NSW, Australia
| | - Prajwal Gyawali
- School of Health and Wellbeing, Faculty of Health, Engineering and Sciences, University of Southern Queensland, Darling Heights, QLD, Australia
| | - Kirsten Coupland
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia,School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW, Australia,Priority Research Centre for Stroke and Brain Injury, The University of Newcastle, Callaghan, NSW, Australia
| | - Murielle G Kluge
- School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW, Australia,Centre for Advanced Training Systems, The University of Newcastle, Callaghan, NSW, Australia
| | - Angela Smith
- HNE Health Libraries, Hunter New England Local Health District, New Lambton, NSW, Australia
| | - Sue Bowden
- Consumer Investigator, Moon River Turkey, Bathurst, NSW, Australia
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Wu C, Wang B, Shen G. Unobtrusive monitoring of sedentary behaviors with fusion of bluetooth and ballistocardiogram signals. Methods 2022; 202:152-163. [PMID: 34090972 DOI: 10.1016/j.ymeth.2021.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 05/03/2021] [Accepted: 06/01/2021] [Indexed: 11/23/2022] Open
Abstract
Intensive and lasting stress may induce severe damage to a human's physical and mental health. Successful stress management depends on the effective monitoring of people's everyday activities, in particular, their sedentary behaviors. Here, we propose an unobtrusive office sedentary behavior monitoring system that combines Bluetooth signals and ballistocardiogram (BCG) signals to classify an individual's sitting modes into four categories: off-seat, sedate, working, and in-motion. The proposed monitoring system simultaneously reads received signal strength indicators (RSSI) from several fixed Bluetooth Low Energy (BLE) beacons and BCG data from the piezoelectric sensor placed underneath the chair cushion, with distinct sampling frequencies. The raw signals are first denoised with local subspace projection. Then we extract the local spectral features from the reconstructed signal and the signal differences for a two-stage stacking learning algorithm. The temporally classified results establish a desk-based worker's sedentary profile and make possible the timely intervention of physical inactivity. We tested the prototype system for 15 subjects, and the preliminary results achieved 95% accuracy, demonstrating its potential in a real-world application.
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Affiliation(s)
- Chuanmin Wu
- School of Computer Science, Huazhong University of Science and Technology, Wuhan, China
| | - Bingcheng Wang
- School of Software Engineering, Huazhong University of Science and Technology, Wuhan, China
| | - Gang Shen
- School of Software Engineering, Huazhong University of Science and Technology, Wuhan, China.
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Bijani M, Niknam M, Karimi S, Naderi Z, Dehghan A. The effect of peer education based on Pender's health promotion model on quality of life, stress management and self-efficacy of patients with multiple sclerosis: a randomized controlled clinical trial. BMC Neurol 2022; 22:144. [PMID: 35436876 PMCID: PMC9014276 DOI: 10.1186/s12883-022-02671-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 04/12/2022] [Indexed: 11/17/2022] Open
Abstract
Background As a chronic, disabling disease, multiple sclerosis (MS) has challenged healthcare systems in many ways. MS adversely affects patients’ quality of life and self-efficacy and results in psychological stress. The present study was conducted to investigate the effect of peer education based on Pender’s health promotion model on the quality of life, stress management, and self-efficacy of patients with MS in the south of Iran. Methods The present study was a randomized controlled clinical trial. A total of 90 patients were divided into group A intervention group 45 patients) and group B (control group 45 patients). The intervention was peer education based on Pender’s health promotion model. Data were collected using the MS Quality of Life Scale, the Self-efficacy Scale, and the Stress Management Scale. Data analyses were conducted using SPSS version 22. To analyze the data, we used descriptive statistics. Thus, inferential statistics applied included Chi-square, independent-samples t-test, and Repeated measures (ANOVA). The significance level was considered p < 0.05. Results The quality of life, self-efficacy, and stress management mean scores of the intervention group as measured immediately and 3 months after intervention were significant (p < 0.05). As for the control group, however, the difference was not significant. Conclusion Peer education based on Pender’s health promotion model improves patients’ quality of life, stress management, and self-efficacy with multiple sclerosis. Nursing managers and health system policymakers can use this educational approach for patients with other chronic diseases to enhance their quality of life and self-efficacy. Trial registration Iranian Registry of Clinical Trials: IRCT registration number: IRCT20190917044802N3.
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Affiliation(s)
- Mostafa Bijani
- Department of Medical Surgical Nursing, Fasa University of Medical Sciences, Fasa, Iran.
| | - Maryam Niknam
- Student Research Committee, Fasa University of Medical Sciences, Fasa, Iran
| | - Shanaz Karimi
- Department of Medical Surgical Nursing, Fasa University of Medical Sciences, Fasa, Iran
| | - Zeinab Naderi
- Department of Nursing, Sirjan School of Medical Sciences, Sirjan, Iran
| | - Azizallah Dehghan
- NonCommunicable Diseases Research Center (NCDRC), Fasa University of Medical Sciences, Fasa, Iran
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Muradyan A, Macheiner T, Mardiyan M, Sekoyan E, Sargsyan K. The Evaluation of Biomarkers of Physical Activity on Stress Resistance and Wellness. Appl Psychophysiol Biofeedback 2022. [PMID: 35296973 DOI: 10.1007/s10484-022-09538-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2022] [Indexed: 12/02/2022]
Abstract
Physical activity can improve health as well as reduce stress and the risk of developing several widespread diseases. However, there exists no accepted standard biomedical examination-method for stress evaluation. The purpose of this study was to investigate the effect of regular physical activity on stress and wellness as well as the evaluation of potential biomarkers in this field. This study included 105 people (mean age = 36.57 ± 1.4 years) who were randomly assigned into the exercise group 1 (EG-1) (n = 41), the exercise group 2 (EG-2) (n = 30), and the control group (CG) (n = 34). Measurements of stress and wellness were obtained by Multiscan BC-OXI before and after experimental period. This device presents a multifrequency segmental body composition 3D analyser with digital pulse oximeter. The key indicators of stress as well as for wellness were significantly improved in the EG-1. Parasympathetic activity showed significant changes as potential stress biomarker. Statistically significant gender differences were not observed in the comparable groups. The results suggest that the stress resistance and well-being significantly improved in the EG-1 due to regular physical activity. However, further research is necessary to determine effects of physical activity on integral health indicators.
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Moss DP. Review of Paul M. Lehrer & Robert L. Woolfolk (eds.). (2021). Principles and practice of stress management (fourth edition). Guilford. Appl Psychophysiol Biofeedback 2022. [PMID: 35254591 DOI: 10.1007/s10484-022-09537-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 01/20/2022] [Accepted: 02/15/2022] [Indexed: 11/02/2022]
Abstract
Lehrer and Woolfolk are major figures who have led the field of stress management for four decades. Here they have assembled a gifted team of expert authors, ranging from Jonathan Smith on relaxation to Alice Meuret and Thomas Ritz on capnometric training to Shirley Telles and colleagues on yoga for stress management. The text Principles and Practice of Stress Management has long provided the most comprehensive scientifically informed resource for understanding stress and stress management. The fourth edition updates the scientific research, introduces new topics, and sharpens the focus in many chapters. Nevertheless, the preface of the fourth edition emphasizes the continued relevance of this book for the lay audience, human beings seeking guidance for managing their life stress.
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Amanvermez Y, Zhao R, Cuijpers P, de Wit LM, Ebert DD, Kessler RC, Bruffaerts R, Karyotaki E. Effects of self-guided stress management interventions in college students: A systematic review and meta-analysis. Internet Interv 2022; 28:100503. [PMID: 35242591 PMCID: PMC8861419 DOI: 10.1016/j.invent.2022.100503] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 02/07/2022] [Accepted: 02/09/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND College students face several sources of stress. Self-guided stress management interventions offer an excellent opportunity for scaling up evidence-based interventions for self-management of these stresses. However, little is known about the overall effects of these interventions. Increasing this understanding is essential because self-guided stress management interventions might be a cost-effective and acceptable way of providing help to this important segment of the population during a critical life course stage. METHODS We carried out a systematic literature search of bibliographical databases (PubMed, PsycINFO, Embase, and Cochrane Library) for randomized controlled trials (RCTs) of self-guided stress management interventions published up through April 2020. We conducted two separate meta-analyses for perceived stress, depression, and anxiety. The first included interventions for general college student samples. The second included studies for students with high levels of perceived stress. RESULTS The first meta-analysis included 26 studies with 29 intervention-control comparisons based on a total of 4468 students. The pooled effect size was small but statistically significant (g = 0.19; 95% CI [0.10, 0.29]; p < 0.001). Results showed moderate heterogeneity across studies [I 2 = 48%; 95% CI (19, 66%)]. The second meta-analysis, included four studies based on a total of 491 students with high levels of stress. The pooled effect size was small but statistically significant (g = 0.34; 95% CI [0.16, 0.52]; p < 0.001). Results showed no heterogeneity across studies (I 2 = 0%; 95% CI [0, 79%]), but risk of bias was substantial. DISCUSSION Our results suggest that self-guided stress management programs may be effective when compared to control conditions, but with small average effects. These programs might be a useful element of a multi-component intervention system. Given the psychological barriers to treatment that exist among many college students, self-help interventions might be a good first step in facilitating subsequent help-seeking among students reluctant to engage in other types of treatment. More studies should be conducted to investigate these interventions, sample specifications, mediating effects, and individual-level heterogeneity of effects.
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Affiliation(s)
- Yagmur Amanvermez
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands,Corresponding author at: Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7-9, 1081 BT Amsterdam, the Netherlands.
| | - Ruiying Zhao
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands
| | - Leonore M. de Wit
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands
| | - David D. Ebert
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Ronny Bruffaerts
- Universitair Psychiatrisch Centrum, Center for Public Health Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Eirini Karyotaki
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands
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Kris-Etherton PM, Sapp PA, Riley TM, Davis KM, Hart T, Lawler O. The Dynamic Interplay of Healthy Lifestyle Behaviors for Cardiovascular Health. Curr Atheroscler Rep 2022; 24:969-80. [PMID: 36422788 DOI: 10.1007/s11883-022-01068-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW The recent rise in cardiovascular disease (CVD) deaths in the USA has sparked interest in identifying and implementing effective strategies to reverse this trend. Healthy lifestyle behaviors (i.e., healthy diet, regular physical activity, achieve and maintain a healthy weight, avoid tobacco exposure, good quality sleep, avoiding and managing stress) are the cornerstone for CVD prevention. RECENT FINDINGS Achieving all of these behaviors significantly benefits heart health; however, even small changes lower CVD risk. Moreover, there is interplay among healthy lifestyle behaviors where changing one may result in concomitant changes in another behavior. In contrast, the presence of one or more unhealthy lifestyle behaviors may attenuate changing another lifestyle behavior(s) (poor diet, inadequate physical activity, overweight/obesity, poor sleep quality, tobacco exposure, and poor stress management). It is important to assess all of these lifestyle behaviors with patients to plan an intervention program that is best positioned for adherence.
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Shi Y, Lan J. Effect of stress management training in cardiac rehabilitation among coronary artery disease: a systematic review and meta-analysis. Rev Cardiovasc Med 2021; 22:1491-1501. [PMID: 34957788 DOI: 10.31083/j.rcm2204153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/06/2021] [Accepted: 10/22/2021] [Indexed: 11/06/2022] Open
Abstract
The stress management program is not considered as a part of routine cardiac rehabilitation due to the lack of consensus and inconsistencies in the studies detailing the relation between stress and coronary artery disease. The current meta-analysis is intended to determine the effectiveness of stress management in cardiac rehabilitation. The published literature studies until December 2020 were extracted from various databases and eligible studies were selected based on the inclusion and exclusion criteria. Quality assessment of the selected studies was carried out using Jadad. The literature search of various databases yielded 154 studies and 9 were selected based on the inclusion/exclusion criteria. On the Jadad scale, 6 studies obtained a score of 3, whereas the remaining studies obtained a score of 2. Funnel plot findings reported no publication bias. The result of the meta-analysis showed a persistent improvement in Beck depression inventory-2, hospital anxiety scale and hospital depression scale in subjects who had undergone various stress management interventions. The meta-analysis corroborates the benefits of stress management training in cardiac rehabilitation and underscores the need to adopt a stress management program in routine cardiac care.
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Affiliation(s)
- Yan Shi
- Department of Cardiology, The First Hospital of China Medical University, 110001 Shenyang, Liaoning, China
| | - Jing Lan
- Department of Cardiology, The First Hospital of China Medical University, 110001 Shenyang, Liaoning, China
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Azriful, Mallapiang F, Nildawati, Alam S, Jusriani R, Muis M. Stress management for breast cancer survivor in South Sulawesi Province Indonesia. Gac Sanit 2021; 35 Suppl 2:S183-5. [PMID: 34929807 DOI: 10.1016/j.gaceta.2021.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 07/30/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Cancer is still a health problem serious. Based on the Ministry of Health's report, cancer is the second leading cause of death in the world by 13% after cardiovascular disease. Approximately 30% of cancer patients had adjustment problems and 20% were diagnosed with depression. METHODS A qualitative design with an ethnographic and phenomenological approach with a total of 10 participants. RESULT Based on the results of the interview, breast cancer sufferers experience stress and depression when they first find out the diagnosis from the doctor. However, they carry out strategic in order to get rid of excessive anxiety such as reading books, dzikir, meeting fellow survivors, and still trying to sincerely undergo all series of treatments. CONCLUSION Support from family, work environment, friends, relatives, fellow breast cancer survivors and treating doctors and fellow survivors greatly contributes to efforts to prevent stress and depression, fellow survivors have communities and groups to provide information and education as well as sharing related to breast cancer.
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Boß L, Angerer P, Dragano N, Ebert D, Engels M, Heber E, Kuhlmann R, Ruhle S, Schwens C, Wulf IC, Lehr D. Comparative effectiveness of guided internet-based stress management training versus established in-person group training in employees - study protocol for a pragmatic, randomized, non-inferiority trial. BMC Public Health 2021; 21:2177. [PMID: 34837999 PMCID: PMC8626923 DOI: 10.1186/s12889-021-12229-y] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 11/11/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Occupational stress is a major public health challenge that requires a variety of evidence-based preventative approaches to increase their reach within the working population. Behavioral stress management interventions are considered an established approach for occupational stress prevention. Both in-person group-based stress management training (gSMT) and individual Internet-based training (iSMT) have been shown to be effective at reducing stress in employees. However, there remains a lack of evidence on the comparative efficacy of the newer digital format compared to well-established, in-person, group-based training. This study aims (1) to directly compare an evidence-based iSMT with an established gSMT on stress in employees, (2) to analyze the two conditions from a cost perspective, and (3) to explore moderators of the comparative efficacy. METHODS In a randomized, controlled, non-inferiority trial employees from the general working population will be allocated to iSMT or gSMT. The primary outcome will be perceived stress, assessed using the Perceived Stress Scale, three months after randomization. The non-inferiority margin for the primary outcome measure will be set at 2 points (Cohen's d = 0.29). This trial will also compare the two interventions from a health economics perspective, and conduct explorative analyses to identify potential effect moderators. DISCUSSION To reach a larger proportion of the working population, well-established gSMT should be complemented with interventions that fit today's society's increasingly digital lifestyle. The current trial will provide evidence supporting the responsible implementation of Internet-based stress management training if the digital format proves to at least be non-inferior to established group-based training. Additional explorative moderator analyses may guide future practices to aid in matching select programs with select users. TRIAL REGISTRATION German Register of Clinical Studies (DRKS): DRKS00024892, date of registration: 2021-04-09. Protocol version: 02, 16-10-2021.
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Affiliation(s)
- Leif Boß
- Department of Health Psychology and Applied Biological Psychology, Institute of Psychology, Leuphana University Lüneburg, Lüneburg, Germany.
| | - Peter Angerer
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty and University Hospital, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Nico Dragano
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty and University Hospital, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - David Ebert
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Miriam Engels
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty and University Hospital, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Elena Heber
- GET.ON Institut für Online Gesundheitstrainings GmbH, Hamburg, Germany
| | - Rebekka Kuhlmann
- Chair of Business Administration, in particular Work, Human Resource Management and Organization Studies, Faculty of Business Administration and Economics, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Sascha Ruhle
- Chair of Business Administration, in particular Work, Human Resource Management and Organization Studies, Faculty of Business Administration and Economics, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Christian Schwens
- Endowed Chair for Interdisciplinary Management Science, School of Management, Economics and Social Sciences, University of Cologne, Cologne, Germany
| | - Ines Catharina Wulf
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty and University Hospital, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Dirk Lehr
- Department of Health Psychology and Applied Biological Psychology, Institute of Psychology, Leuphana University Lüneburg, Lüneburg, Germany
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Soret R, Montes-Solano AM, Manzini C, Peysakhovich V, Fabre EF. Pushing open the door to reality: On facilitating the transitions from virtual to real environments. Appl Ergon 2021; 97:103535. [PMID: 34298387 DOI: 10.1016/j.apergo.2021.103535] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 06/29/2021] [Accepted: 07/14/2021] [Indexed: 06/13/2023]
Abstract
The recent rise of virtual reality technology has led researchers to investigate how to adapt transitions to virtual environments. Transitions play a key role in facilitating the return to reality, which is of particular importance when the virtual world is far more agreeable than the real world. In the present study, the efficacy of a door transition - an almost "transparent" door falling out the top of the virtual environment and controlled by the user - was evaluated and compared to two basic transitions: a direct transition and a fading transition. Participants reported a strong preference for the door transition that was evaluated as being smoother, more controllable, and greatly facilitated the return to reality. Moreover, the results showed that the door transition triggered no greater sickness in participants than the two other types of transition.
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Affiliation(s)
- Rebai Soret
- ISAE-SUPAERO, Université de Toulouse, France
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Nakao M, Shirotsuki K, Sugaya N. Cognitive-behavioral therapy for management of mental health and stress-related disorders: Recent advances in techniques and technologies. Biopsychosoc Med 2021; 15:16. [PMID: 34602086 DOI: 10.1186/s13030-021-00219-w] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 09/24/2021] [Indexed: 11/14/2022] Open
Abstract
Cognitive–behavioral therapy (CBT) helps individuals to eliminate avoidant and safety-seeking behaviors that prevent self-correction of faulty beliefs, thereby facilitating stress management to reduce stress-related disorders and enhance mental health. The present review evaluated the effectiveness of CBT in stressful conditions among clinical and general populations, and identified recent advances in CBT-related techniques. A search of the literature for studies conducted during 1987–2021 identified 345 articles relating to biopsychosocial medicine; 154 (45%) were review articles, including 14 systemic reviews, and 53 (15%) were clinical trials including 45 randomized controlled trials. The results of several randomized controlled trials indicated that CBT was effective for a variety of mental problems (e.g., anxiety disorder, attention deficit hypersensitivity disorder, bulimia nervosa, depression, hypochondriasis), physical conditions (e.g., chronic fatigue syndrome, fibromyalgia, irritable bowel syndrome, breast cancer), and behavioral problems (e.g., antisocial behaviors, drug abuse, gambling, overweight, smoking), at least in the short term; more follow-up observations are needed to assess the long-term effects of CBT. Mental and physical problems can likely be managed effectively with online CBT or self-help CBT using a mobile app, but these should be applied with care, considering their cost-effectiveness and applicability to a given population.
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Abstract
BACKGROUND Work-related stress can be defined as an individual's reactions to work characteristics and indicates a poor relationship between coping abilities and work environment. If unmanaged, stress can impact mental and physical health (e.g., causing depression and cardiovascular disease). Many individuals use maladaptive stress-coping strategies, such as sedentary activities, unhealthy eating behaviors, and alcohol consumption, which do not contribute to long-term stress management. In contrast, stress reduction programs can help people manage and effectively reduce stress in the long term. OBJECTIVE To gather the state of the art of work-related stress interventions, their efficacy and applications. METHOD The PsycINFO and EBSCOHost databases were used. The search was carried out between January 28 and March 30, 2019. Inclusion criteria were full text available, text in English or Spanish and a study population comprising workers. RESULTS Twenty-nine articles that included interventions involving aromatherapy, bibliotherapy, cognitive-behavioral therapy, exercise, alternative medicine, mindfulness, technology, stress management and sensory intervention were analyzed. The interventions showed significant reductions in stress, anxiety, depression and burnout; however, most of the studies were not based on specific stress models, and control groups often received no intervention whatsoever. As a result, it is challenging to draw conclusions regarding the success of the interventions, especially if they are novel. CONCLUSION The results suggest that there is a broad portfolio of successful interventions regarding work-related stress. Most of the successful interventions were based on mindfulness; however, aerobic exercise and bibliotherapy may also be successful. The structure and level of evidence appear to be very relevant to the development of a successful intervention.
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Affiliation(s)
- Julia Restrepo
- Department of Psychology, EAFIT University, Medellín, Antioquia, Colombia
| | - Mariantonia Lemos
- Department of Psychology, EAFIT University, Medellín, Antioquia, Colombia
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Børøsund E, Varsi C, Clark MM, Ehlers SL, Andrykowski MA, Sleveland HRS, Bergland A, Nes LS. Pilot testing an app-based stress management intervention for cancer survivors. Transl Behav Med 2021; 10:770-780. [PMID: 31330023 PMCID: PMC7413188 DOI: 10.1093/tbm/ibz062] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Psychosocial eHealth intervention programs for cancer survivors are still in their infancy, with inconsistent findings so far in the scientific literature. The aim of this study was to explore system use, usefulness, ease of use, and preliminary effects of Stress Proffen, an app-based cognitive-behavioral stress management intervention for patients with cancer. A feasibility pilot project tested the intervention with cancer survivors (N = 25). The intervention contained (a) one face-to-face introduction session, (b) 10 app-based modules with stress management educational material and exercises, and (c) one follow-up phone call. Post-intervention interviews were conducted and user log-data were extracted. Outcome measures-Perceived Stress Scale (PSS), Anxiety and Depression (Hospital Anxiety and Depression Scale [HADS]), Health-Related Quality of Life (HRQoL; SF-36), and Self-Regulatory Fatigue (SRF-18)-were completed at baseline and post-intervention. Participants were primarily women (84%), age 34-71 (mean 48) and represented a variety of cancer diagnoses (majority breast cancer: 40%). Twenty-two participants completed all (pre-post) questionnaires. Sixteen participants (67%) completed at least 7 of 10 modules within the 8-week study period. Post-intervention interviews described StressProffen as providing a new, appreciated, and easily accessible stress management tool for the cancer survivors. Dependent/paired t-tests showed significant pre-post intervention effects with significant decrease in stress (p = .008), anxiety (p = .019), and self-regulatory fatigue (p = .025), and improved HRQoL (Role Physical, General Health, Vitality, and Role Emotional, all p's <.01). App-based stress management interventions such as StressProffen can provide appreciated support for cancer survivors, should be easy to use, can provide significant stress reduction, and improve emotional well-being. Further testing in a randomized controlled trial is warranted and is in progress. Clinicaltrials.gov: NCT0293961.
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Affiliation(s)
- Elin Børøsund
- Center for Shared Decision Making and Collaborative Care Research, Division of Medicine, Oslo University Hospital, Oslo, Norway
| | - Cecilie Varsi
- Center for Shared Decision Making and Collaborative Care Research, Division of Medicine, Oslo University Hospital, Oslo, Norway
| | - Matthew M Clark
- Department of Psychiatry and Psychology, College of Medicine and Science, Mayo Clinic, Rochester, MN, USA
| | - Shawna L Ehlers
- Department of Psychiatry and Psychology, College of Medicine and Science, Mayo Clinic, Rochester, MN, USA
| | - Michael A Andrykowski
- Department of Behavioral Science, College of Medicine, University of Kentucky, Lexington, KY, USA
| | - Hilde Renate Sætre Sleveland
- Center for Shared Decision Making and Collaborative Care Research, Division of Medicine, Oslo University Hospital, Oslo, Norway
| | - Anne Bergland
- Center for Shared Decision Making and Collaborative Care Research, Division of Medicine, Oslo University Hospital, Oslo, Norway
| | - Lise Solberg Nes
- Center for Shared Decision Making and Collaborative Care Research, Division of Medicine, Oslo University Hospital, Oslo, Norway.,Department of Psychiatry and Psychology, College of Medicine and Science, Mayo Clinic, Rochester, MN, USA.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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Nixon P, Boß L, Heber E, Ebert DD, Lehr D. A three-armed randomised controlled trial investigating the comparative impact of guidance on the efficacy of a web-based stress management intervention and health impairing and promoting mechanisms of prevention. BMC Public Health 2021; 21:1511. [PMID: 34353294 PMCID: PMC8339390 DOI: 10.1186/s12889-021-11504-2] [Citation(s) in RCA: 6] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 07/16/2021] [Indexed: 02/08/2023] Open
Abstract
Background Web-based stress management interventions (SMI) fit increasingly digital lifestyles, reduce barriers of uptake and are easily scalable. SMIs might lower levels of stress in employees and thereby contribute to the prevention of depressive symptomatology. Different guidance formats can impact the efficacy of SMIs, with higher intensity assumed to result in larger effects. However, head-to-head comparisons of guidance formats are rare. This is the first trial to examine the impact of adherence-focused guidance compared to self-help on the efficacy of an occupational SMI compared to a wait list control condition. Additionally, it will be investigated if the SMI enfolds its impact on preventing depressive symptomatology by different pathways through reducing health impairing and increasing promoting factors. Methods A three-armed randomised controlled trial (RCT) on an occupational SMI was conducted. 404 employees with elevated levels of perceived stress (PSS-10 ≥ 22) were randomly assigned to: adherence-focused guidance (AFG), self-help (SH) or a wait list control group (WLC). The primary outcome was perceived stress (PSS-10). Secondary outcomes included health- and work-related measures. A parallel mediation analysis with stress and resilience as mediators for the effect on depression (CES-D) was carried out. Data collection took place at baseline (T1), after 7 weeks (T2) and 6 months (T3). Results The SMI was effective for all groups on the primary and secondary outcomes. For stress, analyses of covariance (ANCOVA) revealed significant group effects at T2 (F2,400 = 36.08, P < .001) and T3 (F2,400 = 37.04, P < .001) with large effect sizes for AFG (T2: d = 0.83; T3: d = 0.85) and SH (T2: d = 0.88; T3: d = 0.91) compared to WLC. No significant group differences were found for the efficacy between AFG and SH on the outcomes. Adherence in terms of completed modules was significantly higher for AFG compared to SH. The SMI’s impact on depression was mediated by perceived stress: a1b1 = − 0.77, 95% CI [− 1.26, − 0.34] and resilience: a2b2 = − 0.62, 95% CI [− 1.05, − 0.26]. Conclusions The SMI was effective for reducing stress and improving other health- and work-related outcomes, irrespective of the guidance format. Results did not demonstrate superiority of adherence-focused guidance for the efficacy but for adherence in terms of completed modules. Among other reasons, better communication strategies about offered guidance and awareness-raising measures are discussed. Results from mediation analysis suggest that preventive SMIs should be designed to reach two goals: reducing the risk factor of stress and simultaneously increasing health promoting factors such as resilience. Trial registration German Clinical Trial Registration (DRKS) DRKS00005687, 6/6/2014.
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Affiliation(s)
- Patricia Nixon
- Department of Health Psychology and Applied Biological Psychology, Institute of Psychology, Leuphana University of Lueneburg, Lueneburg, Germany
| | - Leif Boß
- Department of Health Psychology and Applied Biological Psychology, Institute of Psychology, Leuphana University of Lueneburg, Lueneburg, Germany
| | - Elena Heber
- Department for Sport & Health Sciences, Technical University of Munich, Psychology & Digital Mental Health Care, Munich, Germany
| | | | - Dirk Lehr
- Department of Health Psychology and Applied Biological Psychology, Institute of Psychology, Leuphana University of Lueneburg, Lueneburg, Germany.
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Athanasopoulou S, Simos D, Charalampopoulou M, Tentolouris N, Kokkinos A, Bacopoulou F, Aggelopoulou E, Zigkiri E, Chrousos GP, Darviri C, Gonos ES. Significant improvement of stress and aging biomarkers using a novel stress management program with the cognitive restructuring method "Pythagorean Self-Awareness Intervention" in patients with type 2 diabetes mellitus and healthy adults. Mech Ageing Dev 2021; 198:111538. [PMID: 34217756 DOI: 10.1016/j.mad.2021.111538] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/16/2021] [Accepted: 06/29/2021] [Indexed: 12/14/2022]
Abstract
Stress accelerates aging by affecting relevant cellular pathways including, among others, leucocyte telomere length (LTL) and proteasome levels. Their impaired function underlies several age-related and non-communicable conditions, such as type 2 diabetes mellitus. The aim of the present study was to investigate, for the first time, the dynamics of stress-related aging factors in the frame of a novel stress-management technique, the Pythagorean Self Awareness Intervention (PSAI), in healthy volunteers and adults with type 2 diabetes. To this end a cohort of 311 healthy volunteers was initially studied and LTL and proteasome levels were analysed in a subgroup of healthy volunteers and adults with type 2 diabetes who were enrolled in the PSAI, with regards to specific physio- and psychometric characteristics of the participants (baseline and post-intervention). We have found a significant improvement of aging biomarkers and of psycho-/bio-factors in all participants. More specifically, post-intervention, both healthy adults and patients with type 2 diabetes demonstrated improved LTL and proteasome levels. Significant improvements were also observed in psychometric, anthropometric and key metabolic features as well as in hair cortisol. In conclusion our results highlighted potential key targets of such interventions and prognostic tools for the assessment of aging pace in clinical practice.
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Affiliation(s)
- Sophia Athanasopoulou
- Institute of Chemical Biology, National Hellenic Research Foundation (NHRF), Athens, 11635, Greece; Faculty of Medicine, School of Health Sciences, University of Thessaly, Larisa, Greece
| | - Dimitrios Simos
- Postgraduate Course Stress Management and Health Promotion, School of Medicine, National and Kapodistrian University of Athens, Athens, 11527, Greece
| | - Maria Charalampopoulou
- Postgraduate Course Stress Management and Health Promotion, School of Medicine, National and Kapodistrian University of Athens, Athens, 11527, Greece
| | - Nikolaos Tentolouris
- Diabetes Center, First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, 11527, Greece
| | - Alexandros Kokkinos
- Diabetes Center, First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, 11527, Greece
| | - Flora Bacopoulou
- Postgraduate Course Stress Management and Health Promotion, School of Medicine, National and Kapodistrian University of Athens, Athens, 11527, Greece; Center for Adolescent Medicine and UNESCO Chair on Adolescent Health Care, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens, 11527, Greece; University Research Institute of Maternal and Child Health and Precision Medicine, and UNESCO Chair on Adolescent Health Care, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens, 11527, Greece
| | - Elena Aggelopoulou
- Postgraduate Course Stress Management and Health Promotion, School of Medicine, National and Kapodistrian University of Athens, Athens, 11527, Greece
| | - Eleni Zigkiri
- Postgraduate Course Stress Management and Health Promotion, School of Medicine, National and Kapodistrian University of Athens, Athens, 11527, Greece
| | - George P Chrousos
- Postgraduate Course Stress Management and Health Promotion, School of Medicine, National and Kapodistrian University of Athens, Athens, 11527, Greece; University Research Institute of Maternal and Child Health and Precision Medicine, and UNESCO Chair on Adolescent Health Care, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens, 11527, Greece; Division of Endocrinology and Metabolism, Biomedical Research Foundation of the Academy of Athens, Athens, 11527, Greece.
| | - Christina Darviri
- Postgraduate Course Stress Management and Health Promotion, School of Medicine, National and Kapodistrian University of Athens, Athens, 11527, Greece.
| | - Efstathios S Gonos
- Institute of Chemical Biology, National Hellenic Research Foundation (NHRF), Athens, 11635, Greece.
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Urizar GG, Nguyen V, Devera J, Saquillo AJ, Dunne LA, Brayboy C, Dixon-Hamlett A, Clanton-Higgins V, Manning G. Destined for Greatness: A Family-Based Stress Management Intervention for African-American Mothers and their Children. Soc Sci Med 2021; 280:114058. [PMID: 34077878 DOI: 10.1016/j.socscimed.2021.114058] [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] [Subscribe] [Scholar Register] [Revised: 03/18/2021] [Accepted: 05/17/2021] [Indexed: 10/21/2022]
Abstract
RATIONALE African-American mothers in the U.S. experience high rates of stress, placing them at risk for depression, anxiety, and preterm births, and their children at risk for poor social-emotional development later in childhood. Yet, few studies have developed and tested family-based interventions that target optimal management of stress in this population. OBJECTIVE The current mixed methods study examined whether a six-week family-based intervention (e.g., cognitive behavioral stress management intervention component for mothers and mindfulness-based kindness curriculum for their children) was effective in improving psychosocial outcomes among low-income African-American mothers and increasing prosocial behaviors in their children. METHOD Seventy-two mothers (28% pregnant, 72% postpartum) completed pre- and post-intervention assessments of stress, depression, anxiety, and self-efficacy for stress management. Prosocial behaviors for 38 of their children (3-10 years of age) were also assessed via mother's self-report and two observational child assessments of sharing and helping behaviors. Qualitative interviews at post-intervention and reunion focus groups (up to two years later) were also conducted. RESULTS Mothers showed significant reductions in perceived stress, depressive symptoms, and anxiety, as well as improved self-efficacy for stress management at post-intervention. Although observational assessments of children's sharing and helping behaviors did not change, mothers' qualitative responses indicated improvements in their child's prosocial behaviors at home. Qualitative responses also revealed unique stressors that mothers experienced, the short- and long-term impact of these interventions on mothers and their children, and program recommendations. CONCLUSIONS These results support the efficacy of family-based stress management interventions in this at-risk population.
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Affiliation(s)
- Guido G Urizar
- Department of Psychology, California State University, 1250 Bellflower Blvd, Long Beach, CA, 90840-0901, USA.
| | - Vivienne Nguyen
- Department of Psychology, California State University, 1250 Bellflower Blvd, Long Beach, CA, 90840-0901, USA
| | - Jason Devera
- Department of Psychology, California State University, 1250 Bellflower Blvd, Long Beach, CA, 90840-0901, USA
| | - Alexa J Saquillo
- Department of Psychology, California State University, 1250 Bellflower Blvd, Long Beach, CA, 90840-0901, USA
| | - Lauren A Dunne
- Department of Psychology, California State University, 1250 Bellflower Blvd, Long Beach, CA, 90840-0901, USA
| | - Cynthia Brayboy
- Long Beach Department of Health & Human Services, Black Infant Health Program, 3820 Cherry Ave, Long Beach, CA, 90807, USA
| | - Angela Dixon-Hamlett
- Long Beach Department of Health & Human Services, Black Infant Health Program, 3820 Cherry Ave, Long Beach, CA, 90807, USA
| | - Veronica Clanton-Higgins
- Long Beach Department of Health & Human Services, Black Infant Health Program, 3820 Cherry Ave, Long Beach, CA, 90807, USA
| | - Gwendolyn Manning
- Long Beach Department of Health & Human Services, Black Infant Health Program, 3820 Cherry Ave, Long Beach, CA, 90807, USA
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