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Neuropsychology Review Sep 2022Mindfulness-based programs (MBPs) are increasingly utilized to improve mental health. Interest in the putative effects of MBPs on cognitive function is also growing.... (Meta-Analysis)
Meta-Analysis Review
Mindfulness-based programs (MBPs) are increasingly utilized to improve mental health. Interest in the putative effects of MBPs on cognitive function is also growing. This is the first meta-analysis of objective cognitive outcomes across multiple domains from randomized MBP studies of adults. Seven databases were systematically searched to January 2020. Fifty-six unique studies (n = 2,931) were included, of which 45 (n = 2,238) were synthesized using robust variance estimation meta-analysis. Meta-regression and subgroup analyses evaluated moderators. Pooling data across cognitive domains, the summary effect size for all studies favored MBPs over comparators and was small in magnitude (g = 0.15; [0.05, 0.24]). Across subgroup analyses of individual cognitive domains/subdomains, MBPs outperformed comparators for executive function (g = 0.15; [0.02, 0.27]) and working memory outcomes (g = 0.23; [0.11, 0.36]) only. Subgroup analyses identified significant effects for studies of non-clinical samples, as well as for adults aged over 60. Across all studies, MBPs outperformed inactive, but not active comparators. Limitations include the primarily unclear within-study risk of bias (only a minority of studies were considered low risk), and that statistical constraints rendered some p-values unreliable. Together, results partially corroborate the hypothesized link between mindfulness practices and cognitive performance. This review was registered with PROSPERO [CRD42018100904].
Topics: Adult; Aged; Cognition; Executive Function; Humans; Memory, Short-Term; Middle Aged; Mindfulness
PubMed: 34350544
DOI: 10.1007/s11065-021-09519-y -
International Journal of Environmental... Oct 2021Physician's burnout has been recognized as an increasing and significant work-related syndrome, described by the combination of emotional exhaustion (EE) and... (Review)
Review
Physician's burnout has been recognized as an increasing and significant work-related syndrome, described by the combination of emotional exhaustion (EE) and depersonalization (D), together with low personal accomplishment (PA). It has many negative consequences on personal, organizational, and patient care levels. This systematic review aimed to analyze research articles where psychological interventions with elements of mindfulness (PIMs) were used to support physicians in order to reduce burnout and foster empathy and well-being. Systematic searches were conducted in May 2019, within six electronic databases PubMed, EBSCOhost MEDLINE, PsycArticles, Cochrane Library, JSTOR, and Slovenian national library information system. Different combinations of boolean operators were used-mindfulness, empathy, medicine/family medicine/general practice/primary care, burnout, doctors/physicians, intervention, and support group. Additional articles were manually searched from the reference list of the included articles. Studies with other healthcare professionals (not physicians and residents) and/or medical students, and those where PIMs were applied for educational or patient's treatment purposes were excluded. Of 1194 studies identified, 786 screened and 139 assessed for eligibility, there were 18 studies included in this review. Regardless of a specific type of PIMs applied, results, in general, demonstrate a positive impact on empathy, well-being, and reduction in burnout in participating physicians. Compared with other recent systematic reviews, this is unique due to a broader selection of psychological interventions and emphasis on a sustained effect measurement. Given the pandemic of COVID-19, it is of utmost importance that this review includes also interventions based on modern information technologies (mobile apps) and can be used as an awareness-raising material for physicians providing information about feasible and easily accessible interventions for effective burnout prevention and/or reduction. Future research should upgrade self-reported data with objective psychological measures and address the question of which intervention offers more benefits to physicians.
Topics: Burnout, Professional; Burnout, Psychological; COVID-19; Empathy; Humans; Mindfulness; Physicians; Psychosocial Intervention; SARS-CoV-2
PubMed: 34769700
DOI: 10.3390/ijerph182111181 -
East Asian Archives of Psychiatry :... Jun 2020Generalised anxiety disorder (GAD) has harmful effects on physical and mental health and quality of life. Mindfulness-based cognitive therapy (MBCT) is a treatment... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Generalised anxiety disorder (GAD) has harmful effects on physical and mental health and quality of life. Mindfulness-based cognitive therapy (MBCT) is a treatment option for GAD. This meta-analysis was conducted to determine the effectiveness of MBCT on GAD.
METHODS
Two authors independently performed the eligibility, quality assessment, and data extraction processes, and consensus was reached in case of discrepancies. Electronic databases were searched for eligible studies (randomised controlled trials, randomised trials, cluster randomised controlled trials, and clinical trials) up to November 2018 using keywords: mindfulness-based cognitive therapy OR mindfulness based cognitive therapy OR MBCT AND general anxiety disorder OR GAD*. The methodological quality of studies was assessed using the revised Jadad scale. Cohen's formula was used to determine the effect size based on the mean and standard deviation of the changes in the study groups before and after the intervention.
RESULTS
Six studies that compared the effectiveness between MBCT and controls were included for analysis. The mean revised Jadad score of the six studies was 4.3 (range, 3-6). The overall mean effect size was -0.65. The funnel plot of effect sizes in relation to the effect size standard error showed a symmetrical distribution. Compared with controls, MBCT significantly improved the treatment outcome of GAD in all studies, except one.
CONCLUSION
MBCT was effective for treating GAD.
Topics: Anxiety Disorders; Cognitive Behavioral Therapy; Humans; Mindfulness
PubMed: 32611828
DOI: 10.12809/eaap1885 -
International Journal of Environmental... Dec 2021Chronic low back pain (CLBP) is the most common cause of disability worldwide, affecting about 12% to 30% of the adult population. Psychological factors play an... (Meta-Analysis)
Meta-Analysis Review
Chronic low back pain (CLBP) is the most common cause of disability worldwide, affecting about 12% to 30% of the adult population. Psychological factors play an important role in the experience of pain, and may be predictive of pain persistence, disability, and long-term sick leave. The aim of this meta-analysis was to identify and to describe the most common psychological approaches used to treat patients who suffer from CLBP. A systematic search was performed on PubMed/MEDLINE and Cochrane Central. Overall, 16 studies with a total of 1058 patients were included in the analysis. Our results suggest that cognitive behavioral therapy (CBT) and mindfulness-based stress reduction (MBSR) interventions are both associated with an improvement in terms of pain intensity and quality of life when singularly compared to usual care. Disability also improved in both groups when compared to usual care. Significant differences in fear-avoidance beliefs were noted in the CBT group compared to usual care. Therefore, psychological factors are related to and influence CLBP. It is crucial to develop curative approaches that take these variables into account. Our findings suggest that CBT and MBSR modify pain-related outcomes and that they could be implemented in clinical practice.
Topics: Adult; Chronic Pain; Cognitive Behavioral Therapy; Humans; Low Back Pain; Mindfulness; Quality of Life
PubMed: 35010319
DOI: 10.3390/ijerph19010060 -
The Journal of Pain Mar 2024This overview of reviews aimed to summarize the evidence from systematic reviews and meta-analyses of randomized clinical trials of the efficacy of acceptance and... (Meta-Analysis)
Meta-Analysis Review
This overview of reviews aimed to summarize the evidence from systematic reviews and meta-analyses of randomized clinical trials of the efficacy of acceptance and commitment therapy (ACT) for adults with chronic pain in relation to pain intensity, pain-related functioning, quality of life, and psychological factors. The Cumulative Index of Nursing and Allied Health Literature (CINAHL), Embase, PsycINFO, PubMed, and the Cochrane Library databases were searched from inception to July 2, 2023. AMSTAR 2 was used to assess the methodological quality of systematic reviews. The overlap among reviews was calculated. Nine reviews comprising 84 meta-analyses of interest were included. At post-treatment, some meta-analyses mainly showed that ACT can reduce depression symptoms, anxiety symptoms, psychological inflexibility, and pain catastrophizing; and can improve mindfulness, pain acceptance, and psychological flexibility. At three-month follow-up, ACT can reduce depression symptoms and psychological inflexibility, as well as improve pain-related functioning and psychological flexibility. At six-month follow-up, ACT can improve mindfulness, pain-related functioning, pain acceptance, psychological flexibility, and quality of life. At six-twelve-month follow-up, ACT can reduce pain catastrophizing and can improve pain-related functioning. Some methodological and clinical issues are identified in the reviews, such as a very high overlap between systematic reviews, the fact that the certainty of the evidence is often not rated and specific details needed to replicate the interventions reviewed are often not reported. Overall, however, randomized clinical trials and systematic reviews show that ACT can improve outcomes related to chronic pain (eg, pain-related functioning). Future systematic reviews should address the methodological and clinical concerns identified here to produce higher-quality findings. PERSPECTIVE: Despite certain methodological and clinical issues, randomized clinical trials and systematic reviews of ACT appear to show that it can improve outcomes related to chronic pain (eg, psychological factors).
Topics: Adult; Humans; Acceptance and Commitment Therapy; Chronic Pain; Quality of Life; Randomized Controlled Trials as Topic
PubMed: 37748597
DOI: 10.1016/j.jpain.2023.09.013 -
Frontiers in Psychiatry 2023Stress in the healthcare environment causes negative effects in nurses such as burnout, anxiety, and depression. The COVID-19 pandemic has resulted in increased pressure...
BACKGROUND
Stress in the healthcare environment causes negative effects in nurses such as burnout, anxiety, and depression. The COVID-19 pandemic has resulted in increased pressure on medical staff globally, highlighting the potential benefits of mindfulness-based interventions in reducing nurses' stress levels. Despite numerous studies exploring the effect of mindfulness-based training on nurses, the results remain inconclusive.
OBJECTIVE
To systematically evaluate the impact of mindfulness training on nurse's performance and increase the certainty of existing evidence.
METHODS
This study searched various databases, including EBSCO, Embase, Web of Science, PubMed, ProQuest, Scopus, Cochrane Online Library, Wanfang, SinoMed, CNKI, and VIP, for randomized controlled trials on the impact of mindfulness-based interventions for nurses up until 02 December 2022. Two investigators independently screened and extracted data from the articles, while also assessing the risk of bias. The data was analyzed using RevMan 5.4 software.
RESULTS
This review identified 15 studies out of the 2,171 records retrieved, consisting of a total of 1,165 participants who were randomized. Post-intervention analysis provided very-low certainty evidence of moderate effectiveness of mindfulness-based training in reducing stress [standardized mean difference (SMD) = -0.81; 95% confidence interval (CI) = -1.11 to -0.52], with no significant effect on anxiety (SMD = -0.30; 95% CI = -0.72 to 0.13) or depression (SMD = -0.24; 95% CI = -0.55 to 0.07). However, the training was effective in reducing burnout, as demonstrated by the lower scores for emotional exhaustion (SMD = -4.27; 95% CI = -5.94 to -2.59) and depersonalization (SMD = -2.89; 95% CI = -4.24 to -1.54) and higher scores for personal accomplishment (SMD = 2.81; 95% CI = 0.12 to 5.50). There was a sustained improvement in stress levels in the short-term (≤3 months), with delayed benefits for burnout. However, only two studies were available for later follow-ups, and there was no significant evidence of long-term effects.
CONCLUSION
Mindfulness-based training may be a viable intervention for improving the psychological wellbeing of nurses, including reducing stress, burnout.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023387081.
PubMed: 37599884
DOI: 10.3389/fpsyt.2023.1218340 -
The Journal of Orthopaedic and Sports... Aug 2023We aimed to analyze the effects and dose-response relationship of the most effective exercises for improving pain and disability in people with chronic nonspecific neck... (Meta-Analysis)
Meta-Analysis
Resistance, Motor Control, and Mindfulness-Based Exercises Are Effective for Treating Chronic Nonspecific Neck Pain: A Systematic Review With Meta-Analysis and Dose-Response Meta-Regression.
We aimed to analyze the effects and dose-response relationship of the most effective exercises for improving pain and disability in people with chronic nonspecific neck pain. Intervention systematic review with meta-analysis. We searched the PubMed, PEDro, and CENTRAL databases from their inception to September 30, 2022. We included randomized controlled trials that involved people with chronic neck pain adopting a longitudinal exercise intervention and assessed one pain and/or disability outcome. Restricted maximum-likelihood random-effects meta-analyses were modeled separately for resistance, mindfulness-based, and motor control exercises; standardized mean differences (Hedge's , standardized mean difference [SMD]) were effect estimators. Meta-regressions (dependent variable: effect sizes of the interventions; independent variables: training dose and control group effects) were conducted to explore the dose-response relationship for therapy success of any exercise type. We included 68 trials. Compared to true control, effects on pain and disability were significantly larger for resistance exercise (pain: SMD, -1.27; 95% confidence interval [CI]: -2.26, -0.28; | = 96%; disability: SMD, -1.76; 95% CI: -3.16, -0.37; | = 98%), motor control exercise (pain: SMD, -2.29; 95% CI: -3.82, -0.75; | = 98%; disability: SMD, -2.42; 95% CI: -3.38, -1.47; | = 94%), and Yoga/Pilates/Tai Chi/Qui Gong exercise (pain: SMD, 1.91; 95% CI:-3.28, -0.55; | = 96%; disability: SMD, -0.62; 95% CI: -0.85, -0.38; | = 0%). Yoga/Pilates/Tai Chi/Qui Gong exercise was more effective than other exercises (SMD, -0.84; 95% CI: -1.553, -0.13; | = 86%) for reducing pain. For disability, motor control exercise was superior to other exercises (SMD, -0.70; 95% CI: -1.23, -0.17; | = 98%). There was no dose-response relationship for resistance exercise ( = 0.32). Higher frequencies (estimate = -0.10) and longer durations (estimate = -0.11) of motor control exercise had larger effects on pain ( = 0.72). Longer sessions (estimate = -0.13) of motor control exercise had larger effects on disability ( = 0.61). Resistance, mindfulness-based, and motor control exercises were effective for reducing neck pain (very low- to moderate-certainty evidence). Higher frequencies and longer duration of sessions had a significant effect on pain for motor control exercise. .
Topics: Humans; Neck Pain; Mindfulness; Quality of Life; Exercise; Exercise Therapy; Chronic Pain
PubMed: 37339388
DOI: 10.2519/jospt.2023.11820 -
Obesity Reviews : An Official Journal... Nov 2019Common strategies for reducing body weight rely on limiting energy intake and restricting food choices. However, these strategies have often been proven ineffective in... (Meta-Analysis)
Meta-Analysis
Common strategies for reducing body weight rely on limiting energy intake and restricting food choices. However, these strategies have often been proven ineffective in achieving long-term and sustainable weight reduction. More recently, mindful eating as an alternative weight management strategy has gained increasing attention, yet systematic reviews on intuitive or mindful eating published so far present contradictory results. We performed a systematic review and meta-analysis on randomized controlled trials on weight loss programs based on mindful or intuitive eating. We analyzed results using meta-regressions. We included a total of 10 studies and found a significant weight loss effect of mindful/intuitive eating strategies compared with nonintervention controls (-0.348 kg, 95% CI: -0.591 to -0.105, P = 0.005). However, there was no difference compared with conventional diet programs (P = 0.99). Reduction of BMI (-0.137 kg/m , 95% CI: -0.365 to 0.091, P = 0.240) or waist circumference (-0.358 cm, 95% CI: -0.916 to 0.200, P = 0.209) were not statistically significant. Mindful/intuitive eating could be a practical approach to weight control. Limitations of this study include the unbalanced sex, origin, place of residence of the participants, and the short duration of interventions. Future research should aim at investigating long-term effects and include a more heterogeneous study population.
Topics: Analysis of Variance; Diet, Reducing; Energy Intake; Exercise; Feeding Behavior; Humans; Mindfulness; Obesity; Weight Loss; Weight Reduction Programs
PubMed: 31368631
DOI: 10.1111/obr.12918 -
PloS One 2022Mindfulness-based interventions (MBIs) are increasingly being integrated into oncological treatment to mitigate psychological distress and promote emotional and physical... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Mindfulness-based interventions (MBIs) are increasingly being integrated into oncological treatment to mitigate psychological distress and promote emotional and physical well-being. This review aims to provide the most recent evaluation of Mindfulness-Based Stress Reduction (MBSR), Mindfulness-Based Cognitive Therapy (MBCT), and Mindfulness-Based Cancer Recovery (MBCR) treatments, in reducing symptoms of depression, anxiety and CRF in oncology populations.
METHODS
A search using the following search terms was conducted: (mindful* OR mindfulness* OR mindfulness-based* OR MBI* OR MBCT OR MBSR OR MBCR) AND (Oncol* OR cancer OR neoplasm OR lymphoma OR carcinoma OR sarcoma) to obtain relevant publications from five databases: PsycINFO, PubMed, Embase, and MEDLINE by EC, and ProQuest Dissertations & Theses Global from January 2000 to February 2022. 36 independent studies (n = 1677) were evaluated for their overall effect sizes (using random-effects models), subgroup analyses, and quality appraisals. Evaluations were performed separately for non-randomized (K = 20, n = 784) and randomized controlled trials (K = 16, n = 893).
RESULTS
The results showed that MBIs have significant medium effects in reducing symptoms of depression (Hedges' g = 0.43), anxiety (Hedges' g = 0.55) and CRF (Hedges' g = 0.43), which were maintained at least three months post-intervention. MBIs were also superior in reducing symptoms of anxiety (Hedges' g = 0.56), depression (Hedges' g = 0.43), and CRF (Hedges' g = 0.42) in oncology samples relative to control groups. The superiority of MBIs to control groups was also maintained at least three months post-intervention for anxiety and CRF symptoms, but not for depressive symptoms. The risk of bias of the included studies were low to moderate.
CONCLUSIONS
This review found that MBIs reduced symptoms of depression, anxiety and CRF in oncology populations.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO: International Prospective Register of Systematic Reviews: CRD42020143286.
Topics: Anxiety; Depression; Fatigue; Humans; Mindfulness; Neoplasms
PubMed: 35834503
DOI: 10.1371/journal.pone.0269519 -
International Journal of Nursing Studies Apr 2023Lung cancer is one of the most common cancers and poses a physical and psychological threat to patients. Mindfulness-based interventions are emerging forms of... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Lung cancer is one of the most common cancers and poses a physical and psychological threat to patients. Mindfulness-based interventions are emerging forms of psychotherapy that are effective in improving physical and psychological symptoms, but no review has summarized their effectiveness on anxiety, depression, and fatigue in people with lung cancer.
OBJECTIVES
To evaluate the effectiveness of mindfulness-based interventions in reducing anxiety, depression, and fatigue in people with lung cancer.
DESIGN
Systematic review and meta-analysis.
METHODS
We searched the PubMed, Web of Science, Embase, China Biology Medicine disc, Wanfang Data, China National Knowledge Infrastructure, and China Science and Technology Journal databases from inception to 13 April 2022. Eligible studies included randomized controlled trials of people with lung cancer receiving mindfulness-based interventions reporting on the outcomes of anxiety, depression, and fatigue. Two researchers independently reviewed the abstracts and full texts, extracted the data and assessed the risk of bias independently by using the Cochrane 'Risk of bias assessment tool'. The meta-analysis was performed by using Review Manager 5.4, and the effect size was calculated by the standardized mean difference and its 95% confidence interval.
RESULTS
The systematic review included 25 studies (2420 participants), whereas the meta-analysis included 18 studies (1731 participants). Mindfulness-based interventions significantly decreased levels of anxiety [standardized mean difference = -1.15, 95% confidence interval (-1.36, -0.94), Z = 10.75, P < 0.001], depression [standardized mean difference = -1.04, 95% confidence interval (-1.60, -0.48), Z = 3.66, P < 0.001], and fatigue [standardized mean difference = -1.29, 95% confidence interval (-1.66, -0.91), Z = 6.79, P < 0.001]. The subgroup analysis indicated that programs lasting less than eight weeks in length with structured intervention components (e.g., mindfulness-based stress reduction and mindfulness-based cognitive therapy) and 45 min of daily home practice implemented in patients with advanced stage lung cancer showed better effects than programs lasting more than eight weeks in length with less structured components and more than 45 min of daily home practice implemented in patients with mixed stage lung cancer. The overall quality of the evidence was low due to the lack of allocation concealment and blinding and the high risk of bias in most studies (80%).
CONCLUSIONS
Mindfulness-based interventions might be effective in reducing anxiety, depression, and fatigue in people with lung cancer. However, we cannot draw definitive conclusions because the overall quality of the evidence was low. More rigorous studies are needed to confirm the effectiveness and examine which intervention components may be most effective for improved outcomes.
Topics: Humans; Anxiety; Depression; Fatigue; Lung Neoplasms; Mindfulness; Quality of Life
PubMed: 36796118
DOI: 10.1016/j.ijnurstu.2023.104447