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International Journal of Environmental... Mar 2021: Hypertension is among the most important risk factors for cardiovascular diseases, which are considered high mortality risk medical conditions. To date, several... (Meta-Analysis)
Meta-Analysis Review
: Hypertension is among the most important risk factors for cardiovascular diseases, which are considered high mortality risk medical conditions. To date, several studies have reported positive effects of mindfulness-based stress reduction (MBSR) interventions on physical and psychological well-being in other medical conditions, but no meta-analysis on MBSR programs for hypertension has been conducted. Objectives: The objective of this study was to determine the effectiveness of MBSR programs for hypertension. : A systematic review and meta-analysis of randomized controlled trials examining the effects of MBSR on systolic and diastolic blood pressure (BP), anxiety, depression, and perceived stress in people with hypertension or pre-hypertension was conducted. The PubMed/MEDLINE and PsycINFO databases were searched in November 2020 to identify relevant studies. : Six studies were included. The comparison of MBSR versus control conditions on diastolic BP was associated with a statistically significant mean effect size favoring MBSR over control conditions ( = -2.029; 95% confidence interval (CI): -3.676 to -0.383, = 0.016, = 6; 22 effect sizes overall), without evidence of heterogeneity ( = 0.000%). The comparison of MBSR versus control conditions on systolic BP was associated with a mean effect size which was statistically significant only at a marginal level ( = -3.894; 95% CI: -7.736-0.053, = 0.047, = 6; 22 effect sizes overall), without evidence of high heterogeneity ( = 20.772%). The higher the proportion of participants on antihypertensive medications was, the larger the effects of MBSR were on systolic BP ( = -0.750, = -2.73, = 0.003). : MBSR seems to be a promising intervention, particularly effective on the reduction of diastolic BP. More well-conducted trials are required.
Topics: Anxiety; Blood Pressure; Humans; Hypertension; Mindfulness; Stress, Psychological
PubMed: 33799828
DOI: 10.3390/ijerph18062882 -
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 -
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 -
The Journal of Headache and Pain Aug 2021Tension-type headache (TTH) has been ranked the second most prevalent health condition worldwide. Non-pharmacological treatments for TTH are widely used as a supplement... (Meta-Analysis)
Meta-Analysis Review
Manual joint mobilisation techniques, supervised physical activity, psychological treatment, acupuncture and patient education for patients with tension-type headache. A systematic review and meta-analysis.
BACKGROUND
Tension-type headache (TTH) has been ranked the second most prevalent health condition worldwide. Non-pharmacological treatments for TTH are widely used as a supplement or an alternative to medical treatment. However, the evidence for their effects are limited. Therefore, the aim of this study was to review the evidence for manual joint mobilisation techniques, supervised physical activity, psychological treatment, acupuncture and patient education as treatments for TTH on the effect of headache frequency and quality of life.
METHODS
A systematic literature search was conducted from February to July 2020 for clinical guidelines, systematic reviews, and individual randomised controlled trials (RCT). The primary outcomes measured were days with headache and quality of life at the end of treatment along with a number of secondary outcomes. Meta-analyses were performed on eligible RCTs and pooled estimates of effects were calculated using the random-effect model. The overall certainty of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation approach (GRADE). In addition, patient preferences were included in the evaluation.
RESULTS
In all, 13 RCTs were included. Acupuncture might have positive effects on both primary outcomes. Supervised physical activity might have a positive effect on pain intensity at the end of treatment and headache frequency at follow-up. Manual joint mobilisation techniques might have a positive effect on headache frequency and quality of life at follow-up. Psychological treatment might have a positive effect on stress symptoms at the end of treatment. No relevant RCTs were identified for patient education. The overall certainty of evidence was downgraded to low and very low. No serious adverse events were reported. A consensus recommendation was made for patient education and weak recommendations for the other interventions.
CONCLUSION
Based on identified benefits, certainty of evidence, and patient preferences, manual joint mobilisation techniques, supervised physical activity, psychological treatment, acupuncture, and patient education can be considered as non-pharmacological treatment approaches for TTH. Some positive effects were shown on headache frequency, quality of life, pain intensity and stress symptoms. Few studies and low sample sizes posed a challenge in drawing solid conclusions. Therefore, high-quality RCTs are warranted.
Topics: Acupuncture Therapy; Exercise; Headache; Humans; Patient Education as Topic; Tension-Type Headache
PubMed: 34418953
DOI: 10.1186/s10194-021-01298-4 -
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 -
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 -
International Journal of Environmental... Feb 2023Emotional eating (EE) may be defined as a tendency to eat in response to negative emotions and energy-dense and palatable foods, and is common amongst adults with... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Emotional eating (EE) may be defined as a tendency to eat in response to negative emotions and energy-dense and palatable foods, and is common amongst adults with overweight or obesity. There is limited evidence regarding the effectiveness of interventions that address EE.
OBJECTIVES
To synthesize evidence on the effectiveness of EE interventions for weight loss and EE in adults living with overweight or obesity.
METHODS
This is a systematic review and meta-analysis. Adhering to the PRISMA guidance, a comprehensive electronic search was completed up to February 2022. Random effects meta-analysis was carried out to determine the percentage change in weight and EE scores.
RESULTS
Thirty-four studies were included. The combined effect size for percentage weight change was -1.08% (95% CI: -1.66 to -0.49, I = 64.65%, = 37), once adjusted for publication bias. Similarly, the combined effect size for percentage change in EE was -2.37%, (95% CI: -3.76 to -0.99, I = 87.77%, = 46). Cognitive Behavioural Therapy showed the most promise for reducing weight and improving EE.
CONCLUSIONS
Interventions to address EE showed promise in reducing EE and promoted a small amount of weight loss in adults living with overweight or obesity.
Topics: Adult; Humans; Overweight; Obesity; Weight Loss; Cognitive Behavioral Therapy; Emotions
PubMed: 36768088
DOI: 10.3390/ijerph20032722 -
JAMA Internal Medicine Jan 2020Mind-body therapies (MBTs) are emerging as potential tools for addressing the opioid crisis. Knowing whether mind-body therapies may benefit patients treated with... (Meta-Analysis)
Meta-Analysis
IMPORTANCE
Mind-body therapies (MBTs) are emerging as potential tools for addressing the opioid crisis. Knowing whether mind-body therapies may benefit patients treated with opioids for acute, procedural, and chronic pain conditions may be useful for prescribers, payers, policy makers, and patients.
OBJECTIVE
To evaluate the association of MBTs with pain and opioid dose reduction in a diverse adult population with clinical pain.
DATA SOURCES
For this systematic review and meta-analysis, the MEDLINE, Embase, Emcare, CINAHL, PsycINFO, and Cochrane Library databases were searched for English-language randomized clinical trials and systematic reviews from date of inception to March 2018. Search logic included (pain OR analgesia OR opioids) AND mind-body therapies. The gray literature, ClinicalTrials.gov, and relevant bibliographies were also searched.
STUDY SELECTION
Randomized clinical trials that evaluated the use of MBTs for symptom management in adults also prescribed opioids for clinical pain.
DATA EXTRACTION AND SYNTHESIS
Independent reviewers screened citations, extracted data, and assessed risk of bias. Meta-analyses were conducted using standardized mean differences in pain and opioid dose to obtain aggregate estimates of effect size with 95% CIs.
MAIN OUTCOMES AND MEASURES
The primary outcome was pain intensity. The secondary outcomes were opioid dose, opioid misuse, opioid craving, disability, or function.
RESULTS
Of 4212 citations reviewed, 60 reports with 6404 participants were included in the meta-analysis. Overall, MBTs were associated with pain reduction (Cohen d = -0.51; 95% CI, -0.76 to -0.26) and reduced opioid dose (Cohen d = -0.26; 95% CI, -0.44 to -0.08). Studies tested meditation (n = 5), hypnosis (n = 25), relaxation (n = 14), guided imagery (n = 7), therapeutic suggestion (n = 6), and cognitive behavioral therapy (n = 7) interventions. Moderate to large effect size improvements in pain outcomes were found for meditation (Cohen d = -0.70), hypnosis (Cohen d = -0.54), suggestion (Cohen d = -0.68), and cognitive behavioral therapy (Cohen d = -0.43) but not for other MBTs. Although most meditation (n = 4 [80%]), cognitive-behavioral therapy (n = 4 [57%]), and hypnosis (n = 12 [63%]) studies found improved opioid-related outcomes, fewer studies of suggestion, guided imagery, and relaxation reported such improvements. Most MBT studies used active or placebo controls and were judged to be at low risk of bias.
CONCLUSIONS AND RELEVANCE
The findings suggest that MBTs are associated with moderate improvements in pain and small reductions in opioid dose and may be associated with therapeutic benefits for opioid-related problems, such as opioid craving and misuse. Future studies should carefully quantify opioid dosing variables to determine the association of mind-body therapies with opioid-related outcomes.
Topics: Analgesics, Opioid; Chronic Pain; Cognitive Behavioral Therapy; Humans; Meditation; Pain Management
PubMed: 31682676
DOI: 10.1001/jamainternmed.2019.4917 -
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