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Minerva Anestesiologica Aug 2019The underlying clinical condition and the Intensive Care Unit (ICU) environment make critical illness a stressful event. Although the usual management consists of... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
The underlying clinical condition and the Intensive Care Unit (ICU) environment make critical illness a stressful event. Although the usual management consists of sedation, non-pharmacological interventions such as music therapy have been suggested for their drug-sparing effect. Aim of the present review is to assess the current evidence on the effectiveness of music therapy in reducing stress and anxiety in critically ill, adult patients.
EVIDENCE ACQUISITION
A systematic review of publications was undertaken using MEDLINE, CINAHL, Cochrane Library, Scopus, Web of Science, Indice Italiano di Letteratura di Scienze Infermieristiche. We included studies of critically ill patients that assessed any effect of music therapy on stress and anxiety, which were variably assessed according to each study's definition.
EVIDENCE SYNTHESIS
Eleven studies were included (10 RCTs and one quasi-experimental design), for a total of 959 patients (range 17-373). The overall quality of the studies was satisfactory; several potential sources for bias were identified. Music therapy was generally provided as a single, 30'-intervention, ranging from 15 to 60'. Only in two studies was the intervention repeated more than once daily. The control groups were standard care, relaxation, headphones with no music or noise-cancelling headphones. Music therapy determined a significant reduction in the levels of anxiety and stress, as assessed by self-reported scales and physiologic parameters. Pooled analysis was not performed due to the heterogeneity of the interventions.
CONCLUSIONS
Despite significant heterogeneity in trial designs, timing and features of the intervention, music therapy is consistently associated with a reduction in anxiety and stress of critically ill patients.
Topics: Anxiety; Critical Illness; Humans; Music Therapy; Randomized Controlled Trials as Topic; Stress, Psychological
PubMed: 30947484
DOI: 10.23736/S0375-9393.19.13526-2 -
Nurse Education Today Jul 2021Undergraduate nursing students may experience high levels of stress, anxiety or depression. This can not only influence their personal wellbeing and academic... (Review)
Review
OBJECTIVE
Undergraduate nursing students may experience high levels of stress, anxiety or depression. This can not only influence their personal wellbeing and academic performance, but also communication with patients during clinical placement and the quality and safety of the healthcare delivered. The objective of the review was to identify interventions that target stress, anxiety or depressed mood in undergraduate nursing students during their undergraduate course.
REVIEW METHOD
A quantitative systematic review, guided by the Joanna Briggs Institute methodology, was conducted. The review considered studies that included undergraduate nurses, and which evaluated interventions targeting stress, anxiety and depressed mood. The review included experimental studies published in English from 2008 to 2018. A tabulated and narrative summary was utilised to present the results.
RESULTS
A total of 1579 studies were identified following a systematic search and 931 studies were screened by title and abstract. A total of 44 studies were critically appraised resulting in 22 studies for inclusion in the systematic review. The studies focused on stress (10 studies), anxiety (14 studies) and depression (7 studies). The majority of the studies (18 of 22) reported a statistically significant reduction in the stress, anxiety or depression experienced by nursing students who participated in interventions targeting these symptoms. Interventions that sought to improve coping management skills, such as mindfulness-based interventions, were most reported.
CONCLUSION
There are a range of effective interventions that target stress, anxiety or depressed mood among nursing students. The quality of the studies reporting these interventions was found to be variable and generally samples were small with limited follow-up. Studies of mindfulness interventions comprised the largest sample sizes, displayed the highest levels of evidence, and transcended stress, anxiety and depressed mood. Future research would benefit from a co-ordinated approach to build the strength of the body of evidence.
Topics: Adaptation, Psychological; Anxiety; Depression; Education, Nursing, Baccalaureate; Humans; Students, Nursing
PubMed: 33905898
DOI: 10.1016/j.nedt.2021.104877 -
The Lancet. Gastroenterology &... May 2021Inflammatory bowel disease (IBD) is a lifelong condition with no cure. Patients with IBD might experience symptoms of common mental disorders such as anxiety and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Inflammatory bowel disease (IBD) is a lifelong condition with no cure. Patients with IBD might experience symptoms of common mental disorders such as anxiety and depression because of bidirectional communication via the gut-brain axis and chronicity of symptoms, and because of impaired quality of life and reduced social functioning. However, uncertainties remain about the magnitude of this problem. We aimed to assess prevalence of symptoms of anxiety or depression in adult patients with IBD.
METHODS
In this systematic review and meta-analysis, we searched MEDLINE, Embase, Embase Classic, and PsycINFO for papers published from inception to Sept 30, 2020, reporting observational studies that recruited at least 100 adult patients with IBD and that reported prevalence of symptoms of anxiety or depression according to validated screening instruments. We excluded studies that only used a structured interview to assess for these symptoms and studies that did not provide extractable data. We extracted data from published study reports and calculated pooled prevalences of symptoms of anxiety and depression, odds ratios (OR), and 95% CIs.
FINDINGS
Of 5544 studies identified, 77 fulfilled the eligibility criteria, including 30 118 patients in total. Overall, pooled prevalence of anxiety symptoms was 32·1% (95% CI 28·3-36·0) in 58 studies (I=96·9%) and pooled prevalence of depression symptoms was 25·2% (22·0-28·5) in 75 studies (I=97·6%). In studies that reported prevalence of anxiety or depression in patients with Crohn's disease and ulcerative colitis within the same study population, patients with Crohn's disease had higher odds of anxiety symptoms (OR 1·2, 95% CI 1·1-1·4) and depression symptoms (1·2, 1·1-1·4) than patients with ulcerative colitis. Overall, women with IBD were more likely to have symptoms of anxiety than were men with IBD (pooled prevalence 33·8% [95% CI 26·5-41·5] for women vs 22·8% [18·7-27·2] for men; OR 1·7 [95% CI 1·2-2·3]). They were also more likely to have symptoms of depression than men were (pooled prevalence 21·2% [95% CI 15·4-27·6] for women vs 16·2% [12·6-20·3] for men; OR 1·3 [95% CI 1·0-1·8]). The prevalence of symptoms of anxiety (57·6% [95% CI 38·6-75·4]) or depression (38·9% [26·2-52·3]) was higher in patients with active IBD than in patients with inactive disease (38·1% [30·9-45·7] for anxiety symptoms and 24·2% [14·7-35·3] for depression symptoms; ORs 2·5 [95% CI 1·5-4·1] for anxiety and 3·1 [1·9-4·9] for depression).
INTERPRETATION
There is a high prevalence of symptoms of anxiety and depression in patients with IBD, with up to a third of patients affected by anxiety symptoms and a quarter affected by depression symptoms. Prevalence was also increased in patients with active disease: half of these patients met criteria for anxiety symptoms and a third met criteria for depression symptoms. Encouraging gastroenterologists to screen for and treat these disorders might improve outcomes for patients with IBD.
FUNDING
None.
Topics: Adult; Anxiety; Depression; Humans; Inflammatory Bowel Diseases; Prevalence; Risk Factors
PubMed: 33721557
DOI: 10.1016/S2468-1253(21)00014-5 -
Journal of Affective Disorders Aug 2022Social anxiety is highly prevalent and has increased in young adults during the COVID-19 pandemic. Since social anxiety negatively impacts interpersonal functioning,... (Review)
Review
BACKGROUND
Social anxiety is highly prevalent and has increased in young adults during the COVID-19 pandemic. Since social anxiety negatively impacts interpersonal functioning, identifying aspects of social cognition that may be impaired can increase our understanding of the development and maintenance of social anxiety disorder. However, to date, studies examining associations between social anxiety and social cognition have resulted in mixed findings.
METHODS
The aim of this systematic review was to summarize the literature on the association between social anxiety and social cognition, while also considering several potential moderators and covariates that may influence findings.
RESULTS
A systematic search identified 52 studies. Results showed mixed evidence for the association between social anxiety and lower-level social cognitive processes (emotion recognition and affect sharing) and a trend for a negative association with higher-level social cognitive processes (theory of mind and empathic accuracy). Most studies examining valence-specific effects found a significant negative association for positive and neutral stimuli.
LIMITATIONS
Not all aspects of social cognition were included (e.g., attributional bias) and we focused on adults and not children, limiting the scope of the review.
CONCLUSIONS
Future studies would benefit from the inclusion of relevant moderators and covariates, multiple well-validated measures within the same domain of social cognition, and assessments of interpersonal functioning outside of the laboratory. Additional research examining the moderating role of attention or interpretation biases on social cognitive performance, and the potential benefit of social cognitive skills training for social anxiety, could inform and improve existing cognitive behavioral interventions.
Topics: Anxiety; COVID-19; Cognition; Humans; Pandemics; Social Cognition; Social Perception; Young Adult
PubMed: 35490878
DOI: 10.1016/j.jad.2022.04.130 -
Journal of Dentistry Nov 2022To systematically retrieve and assess studies regarding the effectiveness of basic behavioral management techniques (BMTs) in pediatric patients. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To systematically retrieve and assess studies regarding the effectiveness of basic behavioral management techniques (BMTs) in pediatric patients.
DATA SOURCES
Electronic and hand searches were conducted to locate Randomized Controlled Trials (RCTs) reporting on objective and subjective evaluation of anxiety and behavior of children up to 12 years of age. Data extraction and risk of bias evaluation, using the Cochrane risk of bias tool (RoB 2.0 Tool), were performed independently and in duplicate for all included studies. Mean differences and standard deviations were used to summarize the data from each study and meta-analyses were conducted with studies of limited heterogeneity.
STUDY SELECTION
A total of 708 papers were identified and screened, 122 retrieved for full text appraisal and 62 finally included. Results suggested that all basic BMTs have acceptable effectiveness on pediatric patients' anxiety, fear and behavior during dental treatment. Meta-analysis showed a statistically significant difference in favor of distraction for subjective anxiety using Facial scale (Mean diff.: 2.78; 95% CI: -3.08, -0.53; p = 0.005) and Modified Child Dental Anxiety Scale (Mean diff.: 12.76; 95% CI: -6.09, -4.47; p = 0.001) and a non-significant difference for heart rate (Mean diff.: 1.70; 95% CI: -6.54, 0.46; p = 0.09). Music significantly reduced heart rate when compared to a control comparator, underlining the superiority of the BMT (Mean diff.: 2.71; 95% CI: -3.70, -0.59; p = 0.007).
CONCLUSIONS
Limited evidence about efficacy of one technique over another raises important issues on the topic for future research regarding the management of the child patient in the dental setting of the 21st century.
CLINICAL SIGNIFICANCE
Behavioral management comprises a challenge for clinicians, who need to be familiar with a range of techniques to meet patients' needs at individual level and be flexible in their implementation. Appropriate technique should incorporate patients' personality and parents' active involvement, within the contents of the changes in modern societies.
Topics: Child; Humans; Pediatric Dentistry; Anxiety; Anxiety Disorders
PubMed: 36152953
DOI: 10.1016/j.jdent.2022.104303 -
Ethiopian Journal of Health Sciences May 2020Aromatherapy as an alternative and complementary medicine is a well-known method for reducing the symptoms of various physiological processes such as labor experience....
BACKGROUND
Aromatherapy as an alternative and complementary medicine is a well-known method for reducing the symptoms of various physiological processes such as labor experience. The aim of this study was to systematically review the currently available evidences evaluating the use of aromatherapy for management of labor pain and anxiety.
METHODS
In a systematic review, 5 databases (PubMed, SCOPUS, Web of Science, Google Scholar and Scientific Information Database [SID]) were searched, from database inception up to December 2019. Keywords used included (aromatherapy OR ""essential oil" OR "aroma*") AND (pain OR anxiety) AND (labor OR delivery). Using the Cochrane Collaboration's 'Risk of bias' method; the risk of bias in the included studies was evaluated.
RESULTS
A total of 33 studies were verified to meet our inclusion criteria. Most of the included studies were conducted in Iran. Aromatherapy was applied using inhalation, massage, footbath, birthing pool, acupressure, and compress. The most popularly used essential oil in the studies was lavender (13 studies), either as a single essential oil or in a combination with other essential oils. Most of included studies confirmed the positive effect of aromatherapy in reducing labor pain and anxiety.
CONCLUSION
The evidences from this study suggest that aromatherapy, as a complementary and alternative modality, can help in relieving maternal anxiety and pain during labor.
Topics: Anxiety; Aromatherapy; Female; Humans; Labor Pain; Obstetric Labor Complications; Pain Management; Pregnancy; Treatment Outcome
PubMed: 32874088
DOI: 10.4314/ejhs.v30i3.16 -
Midwifery Nov 2021The anxiety mothers experience during pregnancy is well known and may have negative consequences for the emotional, psychological, and social development of newborns.... (Review)
Review
BACKGROUND
The anxiety mothers experience during pregnancy is well known and may have negative consequences for the emotional, psychological, and social development of newborns. Anxiety must therefore be reduced using different strategies.
OBJECTIVE
To determine published non-pharmacological interventions to reduce anxiety during pregnancy, childbirth and postpartum.
METHODS
A systematic peer-review of experimental and quasi-experimental studies was conducted using the PubMed, Scopus, Web of Science (WOS), and CINAHL databases. The quality of the studies was assessed using the Spanish version of the PEDro scale. Two researchers participated independently in the data selection and extraction process.
FINDINGS
587 articles were identified, of which 21 met the eligibility criteria. In eleven studies the intervention was performed during pregnancy, in three of them during labour, in four of them during the postpartum period, and in three of them during pregnancy and postpartum. During pregnancy, the most effective interventions were behavioural activation, cognitive behavioural therapy, yoga, music therapy, and relaxation; during childbirth: aromatherapy; during pregnancy and postpartum: antenatal training, massage by partners, and self-guided book reading with professional telephone assistance.
CONCLUSION AND IMPLICATIONS
The most effective interventions to reduce anxiety were performed either during pregnancy or during the postpartum period, not during labour. Most of the interventions were performed on the women, with few of them being performed on both partners. Non-pharmacological interventions may be applied by nurses and midwives to reduce anxiety during pregnancy, labour and postpartum.
Topics: Anxiety; Anxiety Disorders; Female; Humans; Infant, Newborn; Labor, Obstetric; Parturition; Postpartum Period; Pregnancy
PubMed: 34464836
DOI: 10.1016/j.midw.2021.103126 -
Journal of Clinical Nursing Dec 2022Games are increasingly being used as a means of alleviating pain and anxiety in paediatric patients, in the view that this form of distraction is effective, non-invasive... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Games are increasingly being used as a means of alleviating pain and anxiety in paediatric patients, in the view that this form of distraction is effective, non-invasive and non-pharmacological.
AIMS
To determine whether a game-based intervention (via gamification or virtual reality) during the induction of anaesthesia reduces preoperative pain and anxiety in paediatric patients.
METHODS
A systematic review with meta-analysis of randomised controlled trials was performed in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and using RevMan software. The review was based on a search of the EMBASE, CINAHL, Medline, SciELO and Scopus databases, conducted in July 2021. No restriction was placed on the year of publication.
RESULTS
26 studies were found, with a total study population of 2525 children. Regarding pain reduction, no significant differences were reported. For anxiety during anaesthesia induction, however, a mean difference of -10.62 (95% CI -13.85, -7.39) on the Modified Yale Preoperative Anxiety Scale, in favour of game-based intervention, was recorded.
CONCLUSIONS
Game-based interventions alleviate preoperative anxiety during the induction of anaesthesia in children. This innovative and pleasurable approach can be helpful in the care of paediatric surgical patients.
RELEVANCE TO CLINICAL PRACTICE
In children, preoperative management is a challenging task for healthcare professionals, and game-based strategies could enhance results, improving patients' emotional health and boosting post-surgery recovery. Distractive games-based procedures should be considered for incorporation in the pre-surgery clinical workflow in order to optimise healthcare.
Topics: Humans; Child; Anxiety; Anesthesia, General; Anxiety Disorders; Emotions; Pain
PubMed: 35075716
DOI: 10.1111/jocn.16227 -
Reproductive Health Jul 2021Pregnancy is a time of profound physical and emotional change as well as an increased risk of mental illness. While strengthening social support is a common... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Pregnancy is a time of profound physical and emotional change as well as an increased risk of mental illness. While strengthening social support is a common recommendation to reduce such mental health risk, no systematic review or meta-analysis has yet examined the relationship between social support and mental problems during pregnancy.
METHODS
The PRISMA checklist was used as a guide to systematically review relevant peer-reviewed literature reporting primary data analyses. PubMed, Psych Info, MIDIRS, SCOPUS, and CINAHL database searches were conducted to retrieve research articles published between the years 2000 to 2019. The Newcastle-Ottawa Scale tool was used for quality appraisal and the meta-analysis was conducted using STATA. The Q and the I statistics were used to evaluate heterogeneity. A random-effects model was used to pool estimates. Publication bias was assessed using a funnel plot and Egger's regression test and adjusted using trim and Fill analysis.
RESULT
From the identified 3760 articles, 67 articles with 64,449 pregnant women were part of the current systematic review and meta-analysis. From the total 67 articles, 22 and 45 articles included in the narrative analysis and meta-analysis, respectively. From the total articles included in the narrative analysis, 20 articles reported a significant relationship between low social support and the risk of developing mental health problems (i.e. depression, anxiety, and self-harm) during pregnancy. After adjusting for publication bias, based on the results of the random-effect model, the pooled odds ratio (POR) of low social support was AOR: 1.18 (95% CI: 1.01, 1.41) for studies examining the relationship between low social support and antenatal depression and AOR: 1.97 (95% CI: 1.34, 2.92) for studies examining the relationship between low social support and antenatal anxiety.
CONCLUSION
Low social support shows significant associations with the risk of depression, anxiety, and self-harm during pregnancy. Policy-makers and those working on maternity care should consider the development of targeted social support programs with a view to helping reduce mental health problems amongst pregnant women.
Topics: Anxiety; Female; Humans; Maternal Health Services; Mental Health; Pregnancy; Pregnant Women; Social Support
PubMed: 34321040
DOI: 10.1186/s12978-021-01209-5 -
JAMA Pediatrics Nov 2020There is widespread interest in associations between maternal perinatal depression and anxiety and offspring development; however, to date, there has been no systematic,... (Meta-Analysis)
Meta-Analysis
IMPORTANCE
There is widespread interest in associations between maternal perinatal depression and anxiety and offspring development; however, to date, there has been no systematic, meta-analytic review on the long-term developmental outcomes spanning infancy through adolescence.
OBJECTIVE
To provide a comprehensive systematic review and meta-analysis of the extant literature on associations between maternal perinatal depression and anxiety and social-emotional, cognitive, language, motor, and adaptability outcomes in offspring during the first 18 years of life.
DATA SOURCES
Six databases were searched (CINAHL Complete, Cochrane Library, Embase, Informit, MEDLINE Complete, and PsycInfo) for all extant studies reporting associations between perinatal maternal mental health problems and offspring development to March 1, 2020.
STUDY SELECTION
Studies were included if they were published in English; had a human sample, quantitative data, a longitudinal design, and measures of perinatal depression and/or anxiety and social-emotional, cognitive, language, motor, and/or adaptability development in offspring; and investigated an association between perinatal depression or anxiety and childhood development.
DATA EXTRACTION AND SYNTHESIS
Of 27 212 articles identified, 191 were eligible for meta-analysis. Data were extracted by multiple independent observers and pooled using a fixed- or a random-effects model. A series of meta-regressions were also conducted. Data were analyzed from January 1, 2019, to March 15, 2020.
MAIN OUTCOMES AND MEASURES
Primary outcomes included social-emotional, cognitive, language, motor, and adaptability development in offspring during the first 18 years of life.
RESULTS
After screening, 191 unique studies were eligible for meta-analysis, with a combined sample of 195 751 unique mother-child dyads. Maternal perinatal depression and anxiety were associated with poorer offspring social-emotional (antenatal period, r = 0.21 [95% CI, 0.16-0.27]; postnatal period, r = 0.24 [95% CI, 0.19-0.28]), cognitive (antenatal period, r = -0.12 [95% CI, -0.19 to -0.05]; postnatal period, r = -0.25 [95% CI, -0.39 to -0.09]), language (antenatal period, r = -0.11 [95% CI, -0.20 to 0.02]; postnatal period, r = -0.22 [95% CI, -0.40 to 0.03]), motor (antenatal period, r = -0.07 [95% CI, -0.18 to 0.03]; postnatal period, r = -0.07 [95% CI, -0.16 to 0.03]), and adaptive behavior (antenatal period, r = -0.26 [95% CI, -0.39 to -0.12]) development. Findings extended beyond infancy, into childhood and adolescence. Meta-regressions confirmed the robustness of the results.
CONCLUSIONS AND RELEVANCE
Evidence suggests that perinatal depression and anxiety in mothers are adversely associated with offspring development and therefore are important targets for prevention and early intervention to support mothers transitioning into parenthood and the health and well-being of next-generation offspring.
Topics: Adolescent; Anxiety; Child; Child Development; Child, Preschool; Correlation of Data; Depression; Female; Humans; Infant; Male; Pregnancy
PubMed: 32926075
DOI: 10.1001/jamapediatrics.2020.2910