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Mind-Body Interventions to Reduce Risk for Health Disparities Related to Stress and Strength Among African American Women: The Potential of Mindfulness-Based Stress Reduction, Loving-Kindness, and the NTU Therapeutic Framework. 身心干预以减少非裔美国妇女与压力和力量相关的健康差异风险:正念减压、慈爱和NTU治疗框架的潜力。
Pub Date : 2010-12-14 DOI: 10.1177/1533210110386776
Cheryl L Woods-Giscombé, Angela R Black

In the current article, the authors examine the potential role of mind-body interventions for preventing or reducing health disparities in a specific group-African American women. The authors first discuss how health disparities affect this group, including empirical evidence regarding the influence of biopsychosocial processes (e.g., psychological stress and social context) on disparate health outcomes. They also detail how African American women's unique stress experiences as a result of distinct sociohistorical and cultural experiences related to race and gender potentially widen exposure to stressors and influence stress responses and coping behaviors. Using two independent, but related, frameworks (Superwoman Schema [SWS] and the Strong Black Woman Script [SBW-S]), they discuss how, for African American women, stress is affected by "strength" (vis-à-vis resilience, fortitude, and self-sufficiency) and the emergent health-compromising behaviors related to strength (e.g., emotional suppression, extraordinary caregiving, and self-care postponement). The authors then describe the potential utility of three mind-body interventions-mindfulness-based stress reduction (MBSR), loving-kindness meditation (LKM), and NTU psychotherapy-for specifically targeting the stress-, strength-, and contextually related factors that are thought to influence disparate outcomes for African American women. Self-awareness, self-care, inter- and intrapersonal restorative healing and a redefinition of inner strength may manifest through developing a mindfulness practice to decrease stress-related responses; using LKM to cultivate compassion and forgiveness for self and others; and the balance of independence and interdependence as a grounding NTU principle for redefining strength. The authors conclude with a discussion of potential benefits for integrating key aspects of the interventions with recommendations for future research.

在当前的文章中,作者研究了身心干预在预防或减少特定群体中非裔美国妇女健康差异的潜在作用。作者首先讨论了健康差异如何影响这一群体,包括关于生物心理社会过程(例如,心理压力和社会背景)对不同健康结果影响的经验证据。他们还详细说明了非洲裔美国妇女独特的压力经历是如何由于与种族和性别有关的独特的社会历史和文化经历而可能扩大对压力源的暴露,并影响压力反应和应对行为。使用两个独立但相关的框架(女超人图式[SWS]和坚强的黑人女性剧本[SBW-S]),他们讨论了非裔美国女性的压力如何受到“力量”(参见-à-vis韧性、毅力和自给自足)和与力量相关的紧急健康损害行为(如情绪压抑、过度照顾和自我照顾延迟)的影响。作者随后描述了三种身心干预的潜在效用-基于正念的减压(MBSR),慈爱冥想(LKM)和NTU心理治疗-专门针对压力,力量和环境相关因素,这些因素被认为影响非裔美国妇女的不同结果。自我意识、自我照顾、人与人之间和人与人之间的恢复性治疗以及对内在力量的重新定义可以通过发展正念练习来减少与压力相关的反应来体现;运用LKM培养对自己和他人的同情和宽恕;以及独立和相互依赖的平衡,作为重新定义力量的基本原则。作者最后讨论了将干预措施的关键方面与未来研究的建议结合起来的潜在益处。
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引用次数: 136
Effects of Massage Therapy on African Americans with Type 2 Diabetes Mellitus: A Pilot Study 按摩治疗对非裔美国人2型糖尿病的影响:一项初步研究
Pub Date : 2010-10-01 DOI: 10.1177/1533210110390024
B. G. Edwards, J. Palmer
Aims: African American (AA) subjects with type 2 diabetes mellitus were studied to determine effects of Massage Therapy/Acupressure (MTA) on vital signs (VS): blood pressure (BP), heart rate (HR), blood flow (BF), skin temperature (TEMP), O2 saturation (O2); well-being (WB); glycosylated hemoglobin (A1c), cortisol, and insulin. Method: Eleven AA ages 45 to 72, (8 female/3 males) were subjects. VS were obtained before and after each of 20, 60-minute MTA sessions. BF was measured with a Pulsed Doppler and decibel meter. Blood collections (n = 9) and Well-Being-22 Questionnaires [(WBQ-22) n = 11] were completed at baseline and following the 20th massage. MTA involved acupressure on spine-T-8/T-9, Urinary Bladder-UB17/UB23/U2, Stomach-ST2, Kidney-K5, Renal-R3; and Effleurage-gliding/stroking, Petrissage-kneading, Tapotement-cupping/hacking/pinching of extremities, and back/torso and Vibration Friction-neck. Hand pressure provided massage to the pancreas. VS were analyzed with General Estimation Equations, and Wilcoxon Sign Tests evaluated WBQ-22/blood work. Results: Pre/Post MTA BF increased with sessions (p = .001). Immediately following a MTA session, BP (systolic) increased while HR and TEMP decreased. Over-time MTA therapy led to significant increases in HR and BF, while TEMP decreased. No significant changes in cortisol, A1c, or insulin were noted. WBQ-22 parameters improved insignificantly; +Energy, +Positive WB, and +Total WB. Anxiety/Depression decrease. 19.5%/13.8%, respectively. Conclusions: Immediate effects of MTA were increased BP (systolic) and lower HR and TEMP. Long-term effects were higher resting HR and increased BF, while TEMP significantly decreased. MTA was feasible, well received and could have potential health benefits. Randomized controlled studies are needed to thoroughly explore this therapy as a useful adjunct to conventional allopathic care.
目的:对非裔美国人(AA) 2型糖尿病患者进行研究,以确定按摩疗法/穴位按压(MTA)对生命体征(VS)的影响:血压(BP)、心率(HR)、血流量(BF)、皮肤温度(TEMP)、血氧饱和度(O2);幸福(WB);糖化血红蛋白(A1c),皮质醇和胰岛素。方法:11例AA患者,年龄45 ~ 72岁,其中女8例,男3例。分别在20分钟、60分钟的MTA治疗前后获得VS。用脉冲多普勒和分贝计测量BF。在基线和第20次按摩后分别完成血液采集(n = 9)和幸福感-22问卷[(WBQ-22) n = 11]。MTA包括脊柱- t -8/T-9,膀胱- ub17 /UB23/U2,胃- st2,肾脏- k5,肾脏- r3;和effleura -滑翔/抚摸,petrissar -揉捏,tap -cupping/hacking/捏四肢,以及背部/躯干和振动摩擦颈部。手压为胰腺提供按摩。使用一般估计方程分析VS,并使用Wilcoxon Sign test评估WBQ-22/血液工作。结果:MTA前/后BF随疗程增加而增加(p = .001)。MTA治疗后,血压(收缩压)升高,HR和TEMP降低。随着时间的推移,MTA治疗导致HR和BF显著增加,而TEMP下降。皮质醇、糖化血红蛋白和胰岛素均无明显变化。WBQ-22参数改善不显著;+能量,+正WB和+总WB。焦虑/抑郁减少。分别为19.5%和13.8%。结论:MTA的近期效应是血压(收缩压)升高、心率和体温降低,远期效应是静息心率升高、BF增加,而体温显著降低。MTA是可行的、广受欢迎的,可能有潜在的健康益处。需要随机对照研究来彻底探索这种疗法作为传统对抗疗法的有用辅助。
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引用次数: 3
Medicinal Plants Used in Mapuche Traditional Medicine in Araucanía, Chile: Linking Sociocultural and Religious Values with Local Heath Practices 智利Araucanía马普切传统医学中使用的药用植物:将社会文化和宗教价值观与当地健康实践联系起来
Pub Date : 2010-10-01 DOI: 10.1177/1533210110391077
M. Torri
The vast majority of the medicinal plants in Chile have been studied from a pharmacological point of view. These studies, although giving important insights into the understanding of the Mapuche’s traditional medicine in terms of the therapeutical value of the plants, fail, however, to portray the numerous sociocultural and symbolic aspects of this form of medicine. This article aims to overcome this shortcoming by analyzing the sociocultural and religious values of medicinal plants among the Mapuche’s rural communities in Araucanía, Chile, as well as their role in traditional medicine. The methods utilized combined participant observation with individual interviews with local shamans (machi) and villagers. Data from free-list interviews and conversations with research participants were used to develop a series of semi-structured interview questions on knowledge of herbal medicines and plants. Data show that the therapeutic efficacy of Mapuche medicine is not only based on ‘‘active agents’’ but is also related to the symbolic and religious meaning attributed to the treatments by healers and patients. The article concludes that in order to fully understand the therapeutic efficacy of the plants, it is thus necessary to comprehend the sociocultural context in which they are used.
从药理学角度对智利绝大多数药用植物进行了研究。这些研究虽然从植物的治疗价值方面对理解马普切人的传统医学提供了重要的见解,但却未能描绘出这种医学形式的许多社会文化和象征方面。本文旨在通过分析Araucanía,智利马普切农村社区药用植物的社会文化和宗教价值,以及它们在传统医学中的作用,来克服这一缺点。研究方法采用参与式观察结合对当地萨满(马奇)和村民的个别访谈。从自由列表访谈和与研究参与者的对话中获得的数据被用于开发一系列关于草药和植物知识的半结构化访谈问题。数据显示,马普切医学的治疗效果不仅基于“活性药物”,还与治疗师和患者赋予治疗的象征意义和宗教意义有关。文章的结论是,为了充分了解植物的治疗功效,因此有必要了解它们被使用的社会文化背景。
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引用次数: 12
Yoga as a Complementary Therapy for Clinical Depression 瑜伽作为临床抑郁症的辅助疗法
Pub Date : 2010-10-01 DOI: 10.1177/1533210110387405
Purvi Mehta, M. Sharma
Clinical depression is a common illness, with prevalence of current depressive symptoms in the general population of nearly 10% and lifetime diagnosis almost 16%. Yoga offers an attractive option for complementary therapy of depression. The purpose of this study was to examine research regarding the benefits of yoga for depression, to learn to what extent yoga is beneficial as a complementary therapy for this condition. The method used in this study was a systematic qualitative review of interventions obtained from MEDLINE, CINAHL, and ERIC databases. A total of 18 studies met the criteria. Some of the designs utilized by the interventions were pretest posttest, quasi-experimental and randomized controlled trials. It was found that majority of the interventions (17) were able to significantly reduce depressive symptoms in the patients under study. However, several methodological limitations were identified in the conduct of the intervention trials, which future interventions must consider.
临床抑郁症是一种常见病,在一般人群中,当前抑郁症状的患病率近10%,终生诊断率近16%。瑜伽为抑郁症的补充治疗提供了一个有吸引力的选择。这项研究的目的是检查有关瑜伽对抑郁症的益处的研究,了解瑜伽作为一种补充疗法在多大程度上是有益的。本研究采用的方法是对MEDLINE、CINAHL和ERIC数据库中获得的干预措施进行系统的定性评价。共有18项研究符合标准。干预措施采用的一些设计是前测后测、准实验和随机对照试验。研究发现,大多数干预措施(17项)能够显著减轻被研究患者的抑郁症状。然而,在进行干预试验时发现了一些方法学上的局限性,这是未来干预措施必须考虑的问题。
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引用次数: 48
Feasibility of an Intensive Trial of Modern Dance for Adults with Parkinson Disease 成人帕金森病患者现代舞强化试验的可行性
Pub Date : 2010-04-01 DOI: 10.1177/1533210110383903
G. Batson
Although preliminary evidence supports the psychophysical benefits of dance for adults with Parkinson disease, guidelines for community-based dance programs await further scrutiny for safety and efficacy. This pilot study was designed to assess the feasibility of an intensive trial of group-delivered modern dance for 11 adults with early-to-middle stage Parkinson’s. The Timed ‘‘Up and Go’’ test and the Fullerton Advanced Balance scale were administered to assess balance safety and re-administered at closure along with a self-reported feedback questionnaire. Video recordings were analyzed for qualitative behavioral change. Pre/posttest comparisons from the Timed ‘‘Up and Go’’ test were not significant, while those from the Fullerton Advanced Balance Scale were significant at the .05 level for the group as a whole (p = .01) with an average score change of +3.1 points. Although qualitative results generally concurred with the social benefits associated with an enjoyable form of expressive exercise, important indicators surfaced bearing on future research and community program designs. These include need for more rigorous stratification of participants and adapting dance class structure to address specific group needs to promote motor learning for sustained functional gains.
虽然初步证据支持舞蹈对患有帕金森病的成年人的心理生理益处,但社区舞蹈项目的指导方针尚待进一步审查其安全性和有效性。这项初步研究的目的是评估对11名早期到中期帕金森氏症成年人进行集训现代舞的可行性。使用定时“起跑”测试和Fullerton高级平衡量表来评估平衡安全性,并在关闭时重新进行自我报告反馈问卷。对录像进行定性行为改变分析。Timed“Up and Go”测试的测试前后比较不显著,而Fullerton高级平衡量表的测试前后比较在0.05水平上显著(p = 0.01),平均得分变化为+3.1分。尽管定性结果普遍与令人愉快的表达练习形式相关的社会效益相一致,但重要的指标浮出水面,与未来的研究和社区项目设计有关。其中包括需要更严格的参与者分层和调整舞蹈课程结构以满足特定群体的需求,以促进运动学习以获得持续的功能增益。
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引用次数: 45
A Review of the Effects of Guided Imagery on Cancer Patients with Pain 引导影像治疗癌症患者疼痛的研究进展
Pub Date : 2010-04-01 DOI: 10.1177/1533210110388113
Kelly King
Over half of the patients diagnosed with cancer suffer from pain. Often, analgesic medications do not completely relieve the pain and alternative measures are sought out for relief. Mind—body techniques such as guided imagery (GI) have been thought to be helpful and used as an adjuvant to pain relief. This article evaluates and summarizes studies performed from 2001 to 2008, which investigated the use of GI for relief of cancer pain. Electronic databases were searched with the keywords cancer pain, visualization, and guided imagery, for any studies utilizing GI with an outcome measure of pain. Five studies included pain as either a primary or a secondary outcome measure. In three of those, pain intensity and pain-related distress decreased in the GI intervention versus control. There is inconsistency in the methodological qualities of these trials and further research is necessary to provide better evidence for the use of GI in cancer pain.
超过一半的癌症患者忍受着疼痛的折磨。通常,镇痛药物不能完全缓解疼痛,需要寻找其他缓解措施。身心技术,如引导意象(GI)被认为是有帮助的,并被用作缓解疼痛的辅助手段。本文评估和总结了2001年至2008年进行的研究,这些研究调查了使用GI来缓解癌症疼痛。电子数据库中检索了关键词癌性疼痛、可视化和引导成像,以寻找任何利用GI测量疼痛结果的研究。五项研究将疼痛作为主要或次要的结局指标。在其中的三个实验中,与对照组相比,GI干预组的疼痛强度和疼痛相关的痛苦有所下降。这些试验的方法学质量存在不一致性,需要进一步的研究来为GI在癌症疼痛中的应用提供更好的证据。
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引用次数: 27
Incorporating Mindfulness within Established Theories of Health Behavior 将正念融入健康行为的既定理论
Pub Date : 2010-04-01 DOI: 10.1177/1533210110387815
D. Black
Mindfulness is quickly becoming recognized as an important theoretical construct in health promotion and disease prevention research. Greeson (2009) recently evaluated the basic and clinical research on mindfulness, and the accumulated evidence from this review of the literature suggested that the cultivation of mindfulness has beneficial effects on mental, emotional, and behavioral health and well-being. The notion that mindfulness has a positive influence on health has also been supported by evidence suggesting that mindfulness-based interventions have protective influences on some physiological, psychosocial, and behavioral domains of health among both clinical and nonclinical samples comprising youth (Black, Milam, & Sussman, 2009) and adults (Brown, Ryan, & Creswell, 2007; Grossman, Niemann, Schmidt, & Walach, 2004). These empirical findings lend evidence regarding the effectiveness of mindfulness-based interventions on certain health outcomes; however, relatively little is known regarding the mechanisms whereby mindfulness produces change in health behavior outcomes. In this respect, little attention has been directed toward testable theoretical models underlying mindfulness and its influence on health behavior, even though some recent attention has been directed toward the integration of mindfulness and theories of mental health (Grossman et al., 2004). Thus, integrating mindfulness within existing theories of health behavior is one important next step in mindfulness research, considering the widespread application of mindfulness-based interventions in community, school, and clinic settings. To date, one known study examined mindfulness within the context of a formalized theory of health behavior (Chatzisarantis & Hagger, 2007). This prospective study found that mindfulness moderated the intention–behavior relationship within the Theory of Planned Behavior among a college student sample. According to this study, those respondents higher in trait mindfulness, as measured with the Mindful Attention Awareness scale (MAAS), were more likely to enact their behavioral intentions than less mindful respondents. The implications of this study are important, considering that strengthening the intention–behavior link is a key strategy in health promotion programming. Thus, future studies are needed to develop and rigorously test hypotheses that represent theoretical models which elucidate how mindfulness
正念正迅速成为健康促进和疾病预防研究的重要理论建构。Greeson(2009)最近对正念的基础和临床研究进行了评估,从文献综述中积累的证据表明,正念的培养对心理、情感和行为健康和福祉都有有益的影响。正念对健康有积极影响的观点也得到了证据的支持,证据表明,在包括青少年(Black, Milam, & Sussman, 2009)和成年人(Brown, Ryan, & Creswell, 2007)在内的临床和非临床样本中,基于正念的干预对健康的一些生理、社会心理和行为领域都有保护作用;Grossman, Niemann, Schmidt, & Walach, 2004)。这些实证研究结果为正念干预对某些健康结果的有效性提供了证据;然而,关于正念产生健康行为结果变化的机制,人们所知相对较少。在这方面,很少有人关注正念背后的可测试理论模型及其对健康行为的影响,尽管最近有人关注正念与心理健康理论的整合(Grossman et al., 2004)。因此,考虑到正念干预在社区、学校和诊所的广泛应用,将正念整合到现有的健康行为理论中是正念研究的重要下一步。迄今为止,一项已知的研究在健康行为形式化理论的背景下研究了正念(Chatzisarantis & Hagger, 2007)。本前瞻性研究发现,正念调节了大学生计划行为理论中的意向-行为关系。根据这项研究,用正念注意意识量表(MAAS)测量的正念特征较高的受访者比不太注意的受访者更有可能实施他们的行为意图。考虑到加强意向-行为联系是健康促进规划的关键策略,本研究的意义是重要的。因此,未来的研究需要发展和严格检验代表理论模型的假设,以阐明正念如何
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引用次数: 12
The Psychology of Qi Gong: A Qualitative Study 气功心理学:一个质的研究
Pub Date : 2010-04-01 DOI: 10.1177/1533210110387019
P. Posadzki
This article presents an in-depth, qualitative study, analyzing responses to focus-group interviews regarding individuals’ self-reported experiences and attitudes during Qi Gong practice. Semistructured interviews were conducted with three Qi Gong groups in order to collect research data. These data were transcribed verbatim and subjected to content and thematic analysis across and within groups. The analysis indicates extraordinary experiences of Qi Gong practitioners on various levels of bio-psycho-spiritual/energetic functioning. The results indicate how Qi Gong influences the complexity and multidimensionality of individuals’ health. In the discussion, the author compares and contrasts his results with other recently performed research.
本文提出了一项深入的定性研究,分析了焦点小组访谈中关于个人在气功练习中自我报告的经历和态度的反应。为了收集研究数据,对三个气功组进行了半结构化访谈。这些数据被逐字抄录,并在组间和组内进行内容和专题分析。分析表明气功修炼者在不同层次的生物心理精神/能量功能上的非凡经验。结果表明气功影响个体健康的复杂性和多维性。在讨论中,作者将他的结果与最近进行的其他研究进行了比较和对比。
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引用次数: 11
Mindfulness-Based Stress Reduction: Effect on Emotional Distress in Older Adults 正念减压:对老年人情绪困扰的影响
Pub Date : 2010-04-01 DOI: 10.1177/1533210110387687
L. Young, M. Baime
Objectives: Mindfulness training may help seniors successfully manage the physical and psychological challenges of aging in a manner that reduces distress and promotes vitality. The purpose of this retrospective analysis is to evaluate the impact of mindfulness-based stress reduction (MBSR) training on mood states in older adults. Methods: The authors identified 141 older adults (>60 years) who completed MBSR training. All participants completed the Profile of Mood States-Short Form (POMS-SF) at baseline and following 8 weeks of MBSR. Using paired t tests, the authors evaluated changes in mood following training in MBSR. In a subset analysis, the authors further examined the impact of MBSR training in individuals with the highest scores on depression and anxiety. Primary reasons cited for MBSR enrollment are also reported. Results: Overall emotional distress and all sub-scale mood measurements improved significantly following MBSR training. MBSR training resulted in >50% reduction in the number of older people reporting clinically significant depression and anxiety. Most enrolled in MBSR training to improve stress management skills. Discussion: MBSR training is a promising, group-based intervention for decreasing psychological distress in older adults. Larger randomized controlled trials are needed to confirm study findings.
目标:正念训练可以帮助老年人以一种减少痛苦和促进活力的方式成功地应对衰老带来的生理和心理挑战。回顾性分析的目的是评估正念减压(MBSR)训练对老年人情绪状态的影响。方法:作者确定了141名完成了正念减压训练的老年人(>60岁)。所有参与者在基线和8周的正念减压后完成了情绪状态简表(POMS-SF)。使用配对t检验,作者评估了正念减压训练后情绪的变化。在子集分析中,作者进一步研究了正念减压训练对抑郁和焦虑得分最高的个体的影响。此外,还报告了攻读MBSR的主要原因。结果:在正念减压训练后,整体情绪困扰和所有次级量表情绪测量均有显著改善。正念减压训练导致老年人报告临床显著抑郁和焦虑的人数减少了50%以上。大多数人参加了正念减压训练,以提高压力管理技能。讨论:正念减压训练是减少老年人心理困扰的一种有希望的、基于群体的干预方法。需要更大规模的随机对照试验来证实研究结果。
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引用次数: 87
Increasing Knowledge and Traditional Use of Medicinal Plants by Local Communities in Tamil Nadu: Promoting Self-Reliance at the Grassroots Level Through a Community-Based Entrepreneurship Initiative 增加泰米尔纳德邦当地社区对药用植物的知识和传统使用:通过基于社区的创业倡议促进基层自力更生
Pub Date : 2010-01-01 DOI: 10.1177/1533210110379938
Maria Costanza Torri
The presence of traditional medicine (TM) and medical practitioners in remote areas of the world is well documented by anthropological studies. However, social, cultural, and environmental factors influencing health and traditional health systems are usually analyzed separately, ignoring the interlinkages existing among them and the resulting synergies, as well as the impact these will have on multiple aspects of local communities. This article presents an innovative and integrated approach to the promotion of a traditional health knowledge system through a community-based entrepreneurship initiative, the Gram Mooligai Company Limited (GMCL), operating in Tamil Nadu (India). The field study took place in Tamil Nadu over a period of 4 months. The data were collected through individual and group interviews and were complemented by participant observations. The research highlights the existence of a strong relationship between commercial initiatives centered on ethnomedicine, enhancement of local livelihoods, gender empowerment, and conservation and enhancement of traditional knowledge through community capacity building. The article points out the importance of promoting and sustaining community initiatives such as GMCL with appropriate policies and affirms the necessity of reinforcing the links among culture, conservation, and socioeconomic development of local communities, particularly among the most vulnerable sectors of society.
人类学研究充分记录了世界偏远地区传统医学和医疗从业者的存在。然而,影响健康和传统卫生系统的社会、文化和环境因素通常被单独分析,忽略了它们之间存在的相互联系和由此产生的协同作用,以及它们将对当地社区的多个方面产生的影响。本文提出了一种创新和综合的方法,通过在泰米尔纳德邦(印度)运营的以社区为基础的创业计划——Gram Mooligai Company Limited (GMCL)——来促进传统卫生知识系统。实地研究在泰米尔纳德邦进行,为期4个月。数据是通过个人和小组访谈收集的,并辅以参与者的观察。该研究强调了以民族医学为中心的商业举措、改善当地生计、赋予性别权力以及通过社区能力建设保护和增强传统知识之间存在着密切的关系。文章指出了用适当的政策促进和维持GMCL等社区倡议的重要性,并肯定了加强文化、保护和当地社区社会经济发展之间联系的必要性,特别是在社会最脆弱的群体中。
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引用次数: 1
期刊
Complementary Health Practice Review
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