Body, Mind & Spirit Articles and Latest News

Studies of the safety, effectiveness, and biological action of botanical products are major focuses for the five dietary supplement research centers selected to be jointly funded by the Office of Dietary Supplements and the National Center for Complementary and Alternative Medicine, two components of the National Institutes of Health (NIH). The NIH’s National Cancer Institute is co-supporting two of the five centers.

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Studies of the safety, effectiveness, and biological action of botanical products are major focuses for the five dietary supplement research centers selected to be jointly funded by the Office of Dietary Supplements and the National Center for Complementary and Alternative Medicine, two components of the National Institutes of Health (NIH). The NIH’s National Cancer Institute is co-supporting two of the five centers.

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Throughout the year-long strategic planning process, NCCAM is seeking input from its stakeholders through many different channels, including both in-person and Web-based meetings and workshops and through other online vehicles. We particularly encourage input from the public and will be offering several opportunities for people to contribute their thoughts and feedback.

The draft Strategic Plan has be posted for comment. Comments will be accepted between August 30 and September 30, 2010.

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A preferred music listening intervention to reduce anxiety in older adults with dementia in nursing homes.

J Clin Nurs. 2010 Apr;19(7-8):1056-64

Authors: Sung HC, Chang AM, Lee WL

AIM: This article reports the results of a study evaluating a preferred music listening intervention for reducing anxiety in older adults with dementia in nursing homes. BACKGROUND: Anxiety can have a significant negative impact on older adults’ functional status, quality of life and health care resources. However, anxiety is often under-diagnosed and inappropriately treated in those with dementia. Little is known about the use of a preferred music listening intervention for managing anxiety in those with dementia. DESIGN: A quasi-experimental pretest and posttest design was used. METHODS: This study aimed to evaluate the effectiveness of a preferred music listening intervention on anxiety in older adults with dementia in nursing home. Twenty-nine participants in the experimental group received a 30-minute music listening intervention based on personal preferences delivered by trained nursing staff in mid-afternoon, twice a week for six weeks. Meanwhile, 23 participants in the control group only received usual standard care with no music. Anxiety was measured by Rating Anxiety in Dementia at baseline and week six. Analysis of covariance (ancova) was used to determine the effectiveness of a preferred music listening intervention on anxiety at six weeks while controlling for pretest anxiety, age and marital status. RESULTS: ancova results indicated that older adults who received the preferred music listening had a significantly lower anxiety score at six weeks compared with those who received the usual standard care with no music (F = 12.15, p = 0.001). CONCLUSIONS: Preferred music listening had a positive impact by reducing the level of anxiety in older adults with dementia. RELEVANCE TO CLINICAL PRACTICE: Nursing staff can learn how to implement preferred music intervention to provide appropriate care tailored to the individual needs of older adults with dementia. Preferred music listening is an inexpensive and viable intervention to promote mental health of those with dementia.

PMID: 20492050 [PubMed - indexed for MEDLINE]

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Effects of music therapy on labour pain and anxiety in Taiwanese first-time mothers.

J Clin Nurs. 2010 Apr;19(7-8):1065-72

Authors: Liu YH, Chang MY, Chen CH

AIMS: The purpose of the study was to investigate the effects of music on pain reaction and anxiety during labour. BACKGROUND: Music therapy has been used on clinical medicine. Only few scientific studies validate the value on labour women. DESIGN: Randomised controlled trial. METHODS: Sixty primiparas expected to have a normal spontaneous delivery were randomly assigned to either the experimental group (n = 30) or the control group (n = 30). The experimental group received routine care and music therapy, whereas the control group received routine care only. A self-report visual analogue scale for pain and a nurse-rated present behavioural intensity were used to measure labour pain. Anxiety was measured with a visual analogue scale for anxiety and finger temperature. Pain and anxiety between groups were compared during the latent phase (2-4 cm cervical dilation) and active phase (5-7 cm) separately. RESULTS: Our results revealed that compared with the control group, the experimental group had significantly lower pain, anxiety and a higher finger temperature during the latent phase of labour. However, no significant differences were found between the two groups on all outcome measures during the active phase. CONCLUSIONS: This study provides evidence for the use of music as an empirically based intervention of women for labour pain and anxiety during the latent phase of labour. RELEVANCE TO CLINICAL PRACTICE: The findings support that music listening is an acceptable and non-medical coping strategy for labouring women. Especially, apply in reducing the pain and anxiety for women who are at the early phase of labour.

PMID: 20492051 [PubMed - indexed for MEDLINE]

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Effects of relaxation training on sleep quality and fatigue in patients with breast cancer undergoing adjuvant chemotherapy.

J Clin Nurs. 2010 Apr;19(7-8):1073-83

Authors: Demiralp M, Oflaz F, Komurcu S

AIM: The purpose of this study was to investigate the effect of progressive muscle relaxation training on sleep quality and fatigue in Turkish women with breast cancer undergoing adjuvant chemotherapy. BACKGROUND: Sleep problems and fatigue are highly prevalent in patients with breast cancer. Progressive muscle relaxation training is a promising approach in ameliorating the sleep quality and reducing the fatigue associated with cancer and its treatment. DESIGN: A prospective, repeated measures, quasi-experimental design with control group. METHODS: The study sampling consisted of 27 individuals (14 individuals formed the progressive muscle relaxation group, 13 individuals formed the control group) who met the criteria for inclusion in the study. Progressive muscle relaxation training was given to the progressive muscle relaxation group, but not to the control group. The effect of the progressive muscle relaxation training was measured at different stages of the treatment. A data collection form, Pittsburgh Sleep Quality Index and Piper Fatigue Scale were used to collect the data for this study. RESULTS: The progressive muscle relaxation group experienced a greater increase in improved sleep quality and a greater decrease in fatigue than the control group. CONCLUSIONS: The findings indicated that progressive muscle relaxation training would improve sleep quality and fatigue in patients with breast cancer undergoing adjuvant chemotherapy. RELEVANCE TO CLINICAL PRACTICE: Progressive muscle relaxation training given by a nurse can improve sleep quality and fatigue in patients with breast cancer. It is important to start relaxation training just before chemotherapy to decrease the frequency and severity of sleep problems and symptoms such as fatigue during chemotherapy.

PMID: 20492052 [PubMed - indexed for MEDLINE]

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Pivotal moments and changes in the Bonny Method of Guided Imagery and Music for patients with depression.

J Clin Nurs. 2010 Apr;19(7-8):1139-48

Authors: Lin MF, Hsu MC, Chang HJ, Hsu YY, Chou MH, Crawford P

AIMS: To explore pivotal moments and changes during the Bonny Method of Guided Imagery and Music from the perspective of patients with depression. BACKGROUND: Depression has been described as an extremely difficult experience for people and is characterised by emotional distress and suffering. As depression progresses, symptoms increase and gradually influence all aspects of the lives of those affected. Few studies have been undertaken into the essence of inner and pivotal experiences during Guided Imagery and Music in patients with depression. DESIGN: A qualitative research design and discovery-oriented approach were used as the method of both data gathering and textual analysis. METHODS: This study conducted semi-structured interviews with five patients with depression after each of eight sessions of the Bonny Method of Guided Imagery and Music. Each session took place in a music therapy laboratory. Forty transcripts were organised into categories and analysed according to the discovery-oriented approach of Mahrer and Boulet, considering the dimensions of the Bonny Method of Guided Imagery and Music. Results. Nine patients with depression were recruited from a medical centre in southern Taiwan from 2004-2005. Five successfully completed eight Bonny Method of Guided Imagery and Music sessions. There were 141 statements coded into 10 subthemes and three themes describing pivotal moments: pushing aside the barrier, gaining new insight, moving forward. Each category was supported by three-four themes. The analysis also yielded three meaningful moments: releasing mind-body rigidity, awareness and inspiration, acceptance and inner transformation. Patients described personal emotional, cognitive and behavioural transformation during the Bonny Method of Guided Imagery and Music experiences. CONCLUSIONS: The discovery-oriented approach fulfilled the aim of gaining a valuable understanding of the psychological growth experiences of patients with depression during the Bonny Method of Guided Imagery and Music. RELEVANCE TO CLINICAL PRACTICE: Patients with depression particularly need comfort and caring. It is important that nurses offer interventions as adjuvants to medication. This study supports the feasibility of incorporating the Bonny Method of Guided Imagery and Music into the nursing management of patients with depression. Future studies are suggested to examine the interactive process of music stimulus and the multidimensional nature of imagery.

PMID: 20492059 [PubMed - indexed for MEDLINE]

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Effective interventions for homeless youth: a systematic review.

Am J Prev Med. 2010 Jun;38(6):637-45

Authors: Altena AM, Brilleslijper-Kater SN, Wolf JL

CONTEXT: To date, there has not been clear evidence regarding interventions that are effective in addressing the specific needs of homeless youth. A systematic and comprehensive international review on effective interventions for homeless youth is presented. This study seeks to provide an accurate and complete picture of effective interventions for homeless youth by collecting, summarizing, categorizing, and evaluating quantitative studies (i.e., those that have assessed treatment outcomes). EVIDENCE ACQUISTION: The following databases were searched in 2008: PsycINFO, ERIC, MEDLINE, and Cochrane were searched from 1985 through 2008 using specific key words: interventions and programs, with homeless youth (s), homeless adolescents, street youth (s), runaways and throwaways. In addition, references of key articles were searched by hand. Eleven studies met pre-established inclusion criteria. To determine study quality, a set of operational parameters was formulated to rate each study as either good, fair, or poor. EVIDENCE SYNTHESIS: There is no compelling evidence that specific interventions are effective for homeless youth, owing to moderate study quality and the small number of intervention studies. Conclusions that can be drawn from the studies are limited by the heterogeneity of interventions, participants, methods, and outcome measures. Many interventions focused on reduction of substance abuse, whereas other important outcomes, such as quality of life, have received little attention. No study received a quality rating of good, and four studies were rated as fair. Most convincing, but still marginal, were results of interventions based on cognitive-behavioral approaches, which revealed some positive results on psychological measures. CONCLUSIONS: More methodologically sound research is needed to determine what specific interventions are beneficial for subgroups of homeless youth. Implications for future research are discussed.

PMID: 20494240 [PubMed - indexed for MEDLINE]

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Ongoing provision of individual clinician performance data improves practice behavior.

Anesth Analg. 2010 Aug;111(2):515-9

Authors: Frenzel JC, Kee SS, Ensor JE, Riedel BJ, Ruiz JR

BACKGROUND: Clinical practice guidelines summarize evidence from science and attempt to translate those findings into clinical practice. Pervasive and consistent adoption of these guidelines into daily provider practice has proven slow. METHODS: Using postoperative nausea and vomiting (PONV) prophylaxis guideline compliance as our metric, we compared the effects of continuing medical education (CME) alone (I), CME with a single snapshot of provider compliance (II), and ongoing reporting of provider compliance data without further CME (III). We retrospectively analyzed guideline compliance of 23,279 anesthetics at the University of Texas M.D. Anderson Cancer Center. Compliance was defined as a patient with 1 risk factor for PONV receiving at least 1 antiemetic, 2 risk factors receiving at least 2 antiemetics, and 3 risk factors receiving at least 3 antiemetics. Drugs of the same class were counted as single antiemetic administration. Propofol-based anesthetic techniques were counted as receiving 1 antiemetic. Patients with 0 risk factors for PONV were not included. We estimated the compliance rates for each of the 4 time periods of the study adjusting for multiple observations on the same clinician. Individual performance feedback was given once at 6 months after intervention I coincident with a refresher presentation on PONV (start of intervention II) and on an ongoing quarterly basis during intervention III. RESULTS: Compliance rates were not significantly influenced with CME (intervention I) compared with baseline behavior (54.5% vs 54.4%, P = 0.9140). Significant improvement occurred during the time period when CME was paired with performance data (intervention II) compared with intervention I (59.2% vs 54.4%, P = 0.0002). Further significant improvement occurred when data alone were presented (intervention III) compared with intervention II (65.1% vs 59.2%, P < 0.0001). For patients with 3 risk factors, we saw significant improvement in compliance rates during intervention III (P = 0.0002). In post hoc analysis of overtreatment, the percentage differences between the baseline and time period III decreased as the number of risk factors increased. CONCLUSIONS: We observed the greatest improvement in guideline compliance with ongoing personal performance feedback. Provider feedback can be an effective tool to modify clinical practice but can have unanticipated consequences.

PMID: 20529985 [PubMed - indexed for MEDLINE]

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The staging model in schizophrenia, and its clinical implications.

Psychiatr Danub. 2010 Jun;22(2):211-20

Authors: Agius M, Goh C, Ulhaq S, McGorry P

INTRODUCTION: Illnesses which develop in a complex way are best described in stages, and those stages will describe not only a particular point in the course of the disease but also the appropriate treatment for that stage. This approach has, over the years, proved to be very appropriate for planning the treatment of various cancers. It is suggested that in the same way, it can be very important in planning the treatment of a complex illness such as schizophrenia. We aim to describe the staging model of schizophrenia, show the neuroimaging and clinical evidence for it, and discuss its implications for treatment. METHOD: We propose that the development of schizophrenia can be described in at least three stages; the prodrome, the first episode, and the chronic phase. In order to describe these stages, we will use data derived wherever possible from literature published in Europe, and we will compare this with data produced from other continents of the world, notably Australia. This is done by reference to and examination of the original published literature, in order that this evidence may be tested against criteria for evidence of a staging model which we propose. RESULTS: There is much data, from clinical studies which show that schizophrenia develops over time and that its presentation can be described in at least three stages in the development of a schizophrenic illness; the prodrome, the first episode, and the long term chronic phase. It is also true that there is a pre-morbid phase before the prodrome, where it is possible to identify delays in such signs of early neurodevelopment as early paediatric milestones which may suggest an increased risk of schizophrenia in the future. This is mirrored in descriptions of the MRI findings, with loss of gray matter beginning in the prodrome, as well as in changes in cognition which develop as the illness develops over time. DISCUSSION: It follows from this model that treatment is different in all these three stages, and that the expected outcome of treatment will be different in each of the various stages of the illness. In all the phases of the illness, evidence based psychological interventions, including psycho-education, cognitive therapy, family interventions, and other interventions to prevent relapse work together with medication in order to optimise treatment. CONCLUSION: Consequently, any attempt to optimise treatment in schizophrenia must take into account the different stages of the illness, and target outcomes must be appropriate for these stages. The treatments, both pharmacological and psychological must be appropriate to the stage of the disease. The application of treatment protocols which are inappropriate to the stage of the disease may lead to sub-optimal outcomes, and even to iatrogenic harm.

PMID: 20562749 [PubMed - indexed for MEDLINE]

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