Pub Date : 2026-02-01Epub Date: 2026-01-20DOI: 10.1016/j.eujim.2026.102620
Uğur Doğan, Meltem Sungur
Introduction
Undergraduate nursing students commonly experience poor sleep quality due to irregular sleep patterns, academic pressures, clinical stressors, and excessive caffeine intake, yet the efficacy of the 4–7–8 breathing exercise has not been studied in this population. This study examined the effects of a 4-week 4–7–8 breathing exercise intervention on sleep quality among undergraduate nursing students.
Methods
This randomized controlled trial examined the effects of a 4-week 4–7–8 breathing exercise intervention on sleep quality among undergraduate nursing students at a public university in south-eastern Turkey. Recruited participants were randomly allocated using computer-generated block randomization to either an intervention group (n = 40) that practiced the technique nightly or a control group (n = 42) that received no intervention. The 4–7–8 breathing technique involves inhaling through the nose for 4 s, holding the breath for 7 s, and exhaling through the mouth for 8 s. Sleep quality was assessed pre- and post-intervention using the Pittsburgh Sleep Quality Index (PSQI).
Results
The intervention and control groups, which showed similar baseline characteristics including mean age (21.1 ± 0.7 vs 21.5 ± 2.0 years) and gender distribution (77.5% vs 78.6% female), both demonstrated poor sleep quality at baseline (PSQI > 5). Post-intervention, the intervention group showed significant improvements in total PSQI scores compared to the control group (mean difference:2.76; 95% CI:3.76 to -1.76). Significant between-group improvements were also found for the subscales of subjective sleep quality (mean difference: 0.51; 95% CI:0.78 to -0.24), sleep latency (mean difference: 0.54; 95% CI:0.91 to -0.18), sleep disturbances (mean difference: 0.47; 95% CI:0.71 to -0.22), and daytime dysfunction (mean difference: 0.91; 95% CI:1.25 to -0.56). The control group exhibited no significant changes excluding sleep disturbances. No adverse events were reported.
Conclusions
The 4–7–8 breathing exercise is an effective non-pharmacological intervention for improving sleep quality in undergraduate nursing students. These findings support its integrations into nursing education and clinical practice as a self-care tool and potential therapeutic modality for patients. Future research should explore long-term effects and applicability to other stressed populations.
{"title":"The effect of 4-7-8 breathing exercise training on sleep quality of undergraduate nursing students: A randomized controlled study","authors":"Uğur Doğan, Meltem Sungur","doi":"10.1016/j.eujim.2026.102620","DOIUrl":"10.1016/j.eujim.2026.102620","url":null,"abstract":"<div><h3>Introduction</h3><div>Undergraduate nursing students commonly experience poor sleep quality due to irregular sleep patterns, academic pressures, clinical stressors, and excessive caffeine intake, yet the efficacy of the 4–7–8 breathing exercise has not been studied in this population. This study examined the effects of a 4-week 4–7–8 breathing exercise intervention on sleep quality among undergraduate nursing students.</div></div><div><h3>Methods</h3><div>This randomized controlled trial examined the effects of a 4-week 4–7–8 breathing exercise intervention on sleep quality among undergraduate nursing students at a public university in south-eastern Turkey. Recruited participants were randomly allocated using computer-generated block randomization to either an intervention group (<em>n</em> = 40) that practiced the technique nightly or a control group (<em>n</em> = 42) that received no intervention. The 4–7–8 breathing technique involves inhaling through the nose for 4 s, holding the breath for 7 s, and exhaling through the mouth for 8 s. Sleep quality was assessed pre- and post-intervention using the Pittsburgh Sleep Quality Index (PSQI).</div></div><div><h3>Results</h3><div>The intervention and control groups, which showed similar baseline characteristics including mean age (21.1 ± 0.7 vs 21.5 ± 2.0 years) and gender distribution (77.5% vs 78.6% female), both demonstrated poor sleep quality at baseline (PSQI > 5). Post-intervention, the intervention group showed significant improvements in total PSQI scores compared to the control group (mean difference:2.76; 95% CI:3.76 to -1.76). Significant between-group improvements were also found for the subscales of subjective sleep quality (mean difference: 0.51; 95% CI:0.78 to -0.24), sleep latency (mean difference: 0.54; 95% CI:0.91 to -0.18), sleep disturbances (mean difference: 0.47; 95% CI:0.71 to -0.22), and daytime dysfunction (mean difference: 0.91; 95% CI:1.25 to -0.56). The control group exhibited no significant changes excluding sleep disturbances. No adverse events were reported.</div></div><div><h3>Conclusions</h3><div>The 4–7–8 breathing exercise is an effective non-pharmacological intervention for improving sleep quality in undergraduate nursing students. These findings support its integrations into nursing education and clinical practice as a self-care tool and potential therapeutic modality for patients. Future research should explore long-term effects and applicability to other stressed populations.</div></div><div><h3>The clinical trial registration number</h3><div>NCT06103344 (<span><span>http://clinicaltrials.gov/</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"82 ","pages":"Article 102620"},"PeriodicalIF":1.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146074475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The ketogenic diet (KD) has attracted increasing attention for its potential to modulate the gut microbiota; however, the rapidly expanding literature makes it difficult to identify dominant themes, leading contributors, and research gaps. This study aimed to map global research trends on the KD–gut microbiota relationship using bibliometric methods.
Methods
A bibliometric analysis was conducted using the Scopus database. Records published between January 1, 2009 and December 31, 2024 were included (search updated to January 1, 2025). Bibliometric indicators and performance analyses were computed, and keyword co-occurrence and international collaboration networks were visualized using VOSviewer.
Results
A total of 404 documents were identified. Publication output increased markedly after 2016 and peaked in 2024, indicating growing scientific interest. The most prolific authors and institutions contributed disproportionately to the field, and thematic mapping revealed five dominant clusters, including neurodegenerative diseases, metabolic regulation, and microbiota-related mechanisms. While the field is expanding, the distribution of document types suggests that conceptual and synthesis work remains prominent.
Conclusion
Research on the KD–gut microbiota relationship has grown substantially over the last decade, with clear thematic consolidation around metabolic and neurological outcomes. Future studies should prioritize mechanistic and longitudinal clinical designs and integrate multi-omics approaches to clarify causal pathways and support personalized dietary interventions.
{"title":"Global research trends on the ketogenic diet–gut microbiota relationship: A bibliometric analysis","authors":"Emre Manisalı , Kaan Zıkşahna , Rumeysa Adıyıl , Murat Ihlamur","doi":"10.1016/j.eujim.2026.102615","DOIUrl":"10.1016/j.eujim.2026.102615","url":null,"abstract":"<div><h3>Introduction</h3><div>The ketogenic diet (KD) has attracted increasing attention for its potential to modulate the gut microbiota; however, the rapidly expanding literature makes it difficult to identify dominant themes, leading contributors, and research gaps. This study aimed to map global research trends on the KD–gut microbiota relationship using bibliometric methods.</div></div><div><h3>Methods</h3><div>A bibliometric analysis was conducted using the Scopus database. Records published between January 1, 2009 and December 31, 2024 were included (search updated to January 1, 2025). Bibliometric indicators and performance analyses were computed, and keyword co-occurrence and international collaboration networks were visualized using VOSviewer.</div></div><div><h3>Results</h3><div>A total of 404 documents were identified. Publication output increased markedly after 2016 and peaked in 2024, indicating growing scientific interest. The most prolific authors and institutions contributed disproportionately to the field, and thematic mapping revealed five dominant clusters, including neurodegenerative diseases, metabolic regulation, and microbiota-related mechanisms. While the field is expanding, the distribution of document types suggests that conceptual and synthesis work remains prominent.</div></div><div><h3>Conclusion</h3><div>Research on the KD–gut microbiota relationship has grown substantially over the last decade, with clear thematic consolidation around metabolic and neurological outcomes. Future studies should prioritize mechanistic and longitudinal clinical designs and integrate multi-omics approaches to clarify causal pathways and support personalized dietary interventions.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"82 ","pages":"Article 102615"},"PeriodicalIF":1.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146024084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2026-01-07DOI: 10.1016/j.eujim.2026.102611
Hongsheng Liu , Qi Yang , Guiyuan Pang , Meiyu Huang , Lianxiang Lu , Peiyuan Li , Ben Chen , Lini Huo
Introduction
Network pharmacology is widely used to study the mechanisms of Traditional Chinese Medicine (TCM). However, existing methods do not account for the varying dosages of individual components in TCM formulas, which can affect result reliability. This study aimed to assess the impact of incorporating dosage information into network pharmacology for more accurate evaluation of TCM formulas.
Methods
A quantitative network pharmacology approach was developed by introducing the ‘Score of Quantitative Network Pharmacology’ (SQNP) as an evaluation index. Using Ma Huang Tang (MHT) as a case study, both qualitative and quantitative network pharmacology methods were applied to analyse key targets, Gene Ontology (GO) biological function enrichment, and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment. The effects of dosage weighting were compared across both methods.
Results
The comparative analysis revealed that the quantitative method significantly improved the accuracy of identifying key targets. The top 10 targets were consistent in type but showed a significant change in ranking with the addition of dosage weighting. Biological function and pathway enrichment analysis also demonstrated higher reliability with the quantitative approach. The quantitative network pharmacology method provided a more comprehensive understanding of the therapeutic mechanisms of MHT.
Conclusions
Incorporating dosage information into network pharmacology using the SQNP method enhances the reliability of target identification and biological analysis for TCM formulas, offering a more accurate and scientifically robust evaluation for TCM research.
{"title":"Development of a quantitative network pharmacology approach for TCM formulas: A case study of Ma Huang Tang","authors":"Hongsheng Liu , Qi Yang , Guiyuan Pang , Meiyu Huang , Lianxiang Lu , Peiyuan Li , Ben Chen , Lini Huo","doi":"10.1016/j.eujim.2026.102611","DOIUrl":"10.1016/j.eujim.2026.102611","url":null,"abstract":"<div><h3>Introduction</h3><div>Network pharmacology is widely used to study the mechanisms of Traditional Chinese Medicine (TCM). However, existing methods do not account for the varying dosages of individual components in TCM formulas, which can affect result reliability. This study aimed to assess the impact of incorporating dosage information into network pharmacology for more accurate evaluation of TCM formulas.</div></div><div><h3>Methods</h3><div>A quantitative network pharmacology approach was developed by introducing the ‘Score of Quantitative Network Pharmacology’ (SQNP) as an evaluation index. Using Ma Huang Tang (MHT) as a case study, both qualitative and quantitative network pharmacology methods were applied to analyse key targets, Gene Ontology (GO) biological function enrichment, and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment. The effects of dosage weighting were compared across both methods.</div></div><div><h3>Results</h3><div>The comparative analysis revealed that the quantitative method significantly improved the accuracy of identifying key targets. The top 10 targets were consistent in type but showed a significant change in ranking with the addition of dosage weighting. Biological function and pathway enrichment analysis also demonstrated higher reliability with the quantitative approach. The quantitative network pharmacology method provided a more comprehensive understanding of the therapeutic mechanisms of MHT.</div></div><div><h3>Conclusions</h3><div>Incorporating dosage information into network pharmacology using the SQNP method enhances the reliability of target identification and biological analysis for TCM formulas, offering a more accurate and scientifically robust evaluation for TCM research.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"82 ","pages":"Article 102611"},"PeriodicalIF":1.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145975268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hysterosalpingography (HSG) is a common diagnostic procedure for infertility but often causes pain and anxiety. Non-pharmacological interventions offer potential alternatives to pharmacological pain management.
Methods
A systematic review followed PRISMA 2020 guidelines where a search strategy was applied to extract articles from included databases: PubMed, CINAHL Plus with Full Text, Cochrane Library, EMBASE, DynaMed, Clinical Key, MEDLINE, and Airiti Library, published before December 2024. The Cochrane RoB (Risk of Bias) 2.0 tool was used to assess the risk of bias, and the GRADE (Grading of Recommendations Assessment, Development and Evaluation) criteria were applied to evaluate study evidence.
Results
Eight randomized controlled trials (RCTs) met the inclusion criteria, covering educational counseling, virtual reality (VR), music therapy, mobile-assisted education (MAEC), and acupoint warming therapy. Educational counseling improved patient preparedness and reduced pain, technology-assisted interventions diverted attention, and acupoint warming therapy with music provided dual physiological and psychological benefits. It was also observed that anxiety was reduced in three related articles although study quality varied, with some limitations in blinding and sample size.
Conclusion
Non-pharmacological interventions reduced pain (low certainty) and anxiety (very low certainty) during hysterosalpingography. Concerns remain about the methodological quality, small sample sizes, heterogeneity in the interventions, and for anxiety outcomes, inconsistent effects. Further high-quality studies are needed to determine the optimal application, refine implementation, and support evidence-based application.
子宫输卵管造影（HSG）是一种常见的不孕症诊断方法，但经常引起疼痛和焦虑。非药物干预提供了潜在的替代药物疼痛管理。方法按照PRISMA 2020指南进行系统评价，采用检索策略从PubMed、CINAHL Plus全文、Cochrane Library、EMBASE、DynaMed、Clinical Key、MEDLINE和Airiti Library等数据库中提取2024年12月前发表的文章。采用Cochrane RoB (Risk of Bias) 2.0工具评估偏倚风险，采用GRADE （Grading of Recommendations Assessment, Development and Evaluation）标准评估研究证据。结果8项随机对照试验（rct）符合纳入标准，涵盖教育咨询、虚拟现实（VR）、音乐治疗、移动辅助教育（MAEC）和穴位温疗。教育咨询改善了病人的准备，减少了疼痛，技术辅助干预转移了注意力，穴位温热疗法与音乐提供了双重生理和心理上的好处。还观察到，尽管研究质量各不相同，在盲法和样本量方面存在一些限制，但三篇相关文章的焦虑程度有所降低。结论非药物干预减少了子宫输卵管造影时的疼痛（低确定性）和焦虑（极低确定性）。对方法质量、小样本量、干预措施的异质性以及焦虑结果不一致的影响的担忧仍然存在。需要进一步的高质量研究来确定最佳应用，改进实施，并支持循证应用。
{"title":"Non-pharmacological interventions for reducing pain and anxiety in women experiencing infertility undergoing hysterosalpingography: A systematic review without meta-analysis","authors":"Shu-Hsien Fang , Ping-Shaou Yu , Bih-O Lee , Chien-Jen Chen","doi":"10.1016/j.eujim.2025.102609","DOIUrl":"10.1016/j.eujim.2025.102609","url":null,"abstract":"<div><h3>Introduction</h3><div>Hysterosalpingography (HSG) is a common diagnostic procedure for infertility but often causes pain and anxiety. Non-pharmacological interventions offer potential alternatives to pharmacological pain management.</div></div><div><h3>Methods</h3><div>A systematic review followed PRISMA 2020 guidelines where a search strategy was applied to extract articles from included databases: PubMed, CINAHL Plus with Full Text, Cochrane Library, EMBASE, DynaMed, Clinical Key, MEDLINE, and Airiti Library, published before December 2024. The Cochrane RoB (Risk of Bias) 2.0 tool was used to assess the risk of bias, and the GRADE (Grading of Recommendations Assessment, Development and Evaluation) criteria were applied to evaluate study evidence.</div></div><div><h3>Results</h3><div>Eight randomized controlled trials (RCTs) met the inclusion criteria, covering educational counseling, virtual reality (VR), music therapy, mobile-assisted education (MAEC), and acupoint warming therapy. Educational counseling improved patient preparedness and reduced pain, technology-assisted interventions diverted attention, and acupoint warming therapy with music provided dual physiological and psychological benefits. It was also observed that anxiety was reduced in three related articles although study quality varied, with some limitations in blinding and sample size.</div></div><div><h3>Conclusion</h3><div>Non-pharmacological interventions reduced pain (low certainty) and anxiety (very low certainty) during hysterosalpingography. Concerns remain about the methodological quality, small sample sizes, heterogeneity in the interventions, and for anxiety outcomes, inconsistent effects. Further high-quality studies are needed to determine the optimal application, refine implementation, and support evidence-based application.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"82 ","pages":"Article 102609"},"PeriodicalIF":1.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2026-01-07DOI: 10.1016/j.eujim.2026.102612
Wen-juan Song , Xing Wang , Xiao-gang Du
Introduction
The application of data mining in Traditional Chinese Medicine (TCM) has gained considerable momentum in recent years. As bibliometric analysis can systematically quantify scientific outputs and identify research trends and knowledge gaps, we used this method to complement traditional literature reviews. This approach helps mitigate potential selection bias and provides a comprehensive perspective on the field's evolution. This study aims to characterize the research landscape of data mining in TCM by integrating bibliometric analysis with a literature review. We sought to identify technological trends, research hotspots, and clinical translation potential to guide future research.
Methods
We employed a combined approach of bibliometric analysis and literature review. We conducted a comprehensive literature search in the Web of Science Core Collection (WoSCC), including the Science Citation Index Expanded (SCIE) and Social Sciences Citation Index (SSCI) databases, covering publications from 2010 to 2025. Bibliometric analysis and visualization were performed using OriginPro2024, Bibliometrix(v5.0), VOSviewer(v1.6.20), and CiteSpace(v6.3.R1). To ensure comprehensive coverage, we also reviewed clinical and application studies from the China National Knowledge Infrastructure (CNKI) database, emphasizing TCM diagnosis, herb mining, and translational challenges.
Results
Among the 1501 publications analyzed, the field grew rapidly after 2020, with output peaking at 325 publications in 2024. China and the United States emerged as the leading contributing countries, with Beijing University of Chinese Medicine being among the top-performing institutions. Frequently used keywords included “machine learning,” “deep learning,” and “network pharmacology.” The research focus evolved through two distinct stages: correlation and application. However, clinical translation remains limited due to challenges such as data heterogeneity and difficulties in algorithm integration.
Conclusion
Bibliometric analysis and literature review together provide valuable evidence to guide the development of TCM data mining. Future studies should focus on developing algorithms capable of handling complex data, building standardized knowledge bases, and fostering international and cross-disciplinary collaboration to accelerate clinical translation.
近年来，数据挖掘在中医领域的应用取得了长足的发展。由于文献计量分析可以系统地量化科学产出，识别研究趋势和知识差距，我们使用该方法来补充传统的文献综述。这种方法有助于减轻潜在的选择偏差，并为该领域的演变提供了一个全面的视角。本研究旨在通过文献计量分析与文献综述相结合的方法来描绘中医数据挖掘的研究格局。我们试图确定技术趋势、研究热点和临床转化潜力，以指导未来的研究。方法采用文献计量分析和文献回顾相结合的方法。我们对Web of Science Core Collection （WoSCC）进行了全面的文献检索，包括科学引文索引扩展（SCIE）和社会科学引文索引（SSCI）数据库，涵盖了2010年至2025年的出版物。使用OriginPro2024、Bibliometrix（v5.0）、VOSviewer（v1.6.20）和CiteSpace（v6.3.R1）进行文献计量学分析和可视化。为了确保全面的覆盖，我们还回顾了中国知网数据库中的临床和应用研究，重点介绍了中医诊断、草药挖掘和翻译挑战。结果在分析的1501篇论文中，该领域在2020年后增长迅速，2024年达到325篇论文的峰值。中国和美国成为贡献最多的国家，其中北京中医药大学名列前茅。经常使用的关键词包括“机器学习”、“深度学习”和“网络药理学”。研究焦点的演变经历了相关性和应用两个不同的阶段。然而，由于数据异质性和算法集成困难等挑战，临床翻译仍然受到限制。结论文献计量分析和文献综述为中医数据挖掘的发展提供了有价值的依据。未来的研究应侧重于开发能够处理复杂数据的算法，建立标准化的知识库，促进国际和跨学科合作，以加速临床翻译。
{"title":"Data mining in traditional Chinese medicine: a bibliometric analysis and literature review of research trends and clinical applications (2010–2025)","authors":"Wen-juan Song , Xing Wang , Xiao-gang Du","doi":"10.1016/j.eujim.2026.102612","DOIUrl":"10.1016/j.eujim.2026.102612","url":null,"abstract":"<div><h3>Introduction</h3><div>The application of data mining in Traditional Chinese Medicine (TCM) has gained considerable momentum in recent years. As bibliometric analysis can systematically quantify scientific outputs and identify research trends and knowledge gaps, we used this method to complement traditional literature reviews. This approach helps mitigate potential selection bias and provides a comprehensive perspective on the field's evolution. This study aims to characterize the research landscape of data mining in TCM by integrating bibliometric analysis with a literature review. We sought to identify technological trends, research hotspots, and clinical translation potential to guide future research.</div></div><div><h3>Methods</h3><div>We employed a combined approach of bibliometric analysis and literature review. We conducted a comprehensive literature search in the Web of Science Core Collection (WoSCC), including the Science Citation Index Expanded (SCIE) and Social Sciences Citation Index (SSCI) databases, covering publications from 2010 to 2025. Bibliometric analysis and visualization were performed using OriginPro2024, Bibliometrix(v5.0), VOSviewer(v1.6.20), and CiteSpace(v6.3.R1). To ensure comprehensive coverage, we also reviewed clinical and application studies from the China National Knowledge Infrastructure (CNKI) database, emphasizing TCM diagnosis, herb mining, and translational challenges.</div></div><div><h3>Results</h3><div>Among the 1501 publications analyzed, the field grew rapidly after 2020, with output peaking at 325 publications in 2024. China and the United States emerged as the leading contributing countries, with Beijing University of Chinese Medicine being among the top-performing institutions. Frequently used keywords included “machine learning,” “deep learning,” and “network pharmacology.” The research focus evolved through two distinct stages: correlation and application. However, clinical translation remains limited due to challenges such as data heterogeneity and difficulties in algorithm integration.</div></div><div><h3>Conclusion</h3><div>Bibliometric analysis and literature review together provide valuable evidence to guide the development of TCM data mining. Future studies should focus on developing algorithms capable of handling complex data, building standardized knowledge bases, and fostering international and cross-disciplinary collaboration to accelerate clinical translation.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"82 ","pages":"Article 102612"},"PeriodicalIF":1.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147384808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2026-01-20DOI: 10.1016/j.eujim.2026.102619
Camille L. Garnsey , Katherine E. Gnall , Joshua A. Wilt , Crystal L. Park , Sara Lazar
<div><h3>Introduction</h3><div>Yoga practice is associated with improved emotional well-being (EWB), but little is known about the mechanisms of yoga that support EWB This post-hoc secondary analysis of a randomized controlled trial tested a) whether changes in self-compassion and interoceptive awareness were associated with changes in EWB (i.e., meaning in life, sense of inner peace, ability to pursue goals) over the course of a yoga intervention, and b) whether amount practiced relates to changes in proposed mechanisms and EWB outcomes.</div></div><div><h3>Methods</h3><div>Eighty-four participants who self-identified as stressed were randomized to varying doses of a 12-week Kripalu-style yoga intervention. As part of the parent clinical trial, participants completed self-report surveys at baseline, mid-treatment, and post-treatment assessing self-compassion (Self-Compassion Scale, Short Form), elements of interoceptive awareness (The Multidimensional Assessment of Interoceptive Awareness) and domains of emotional well-being (peace, meaning, ability to pursue goals; Functional Assessment of Chronic Illness Therapy–Spiritual Well-being Scale; Brief Self Control Scale). Seventy-five participants from the parent study had data for at least one of the main study variables and were thus included in this secondary analysis. To examine whether changes in hypothesized mechanisms (self-compassion, interoceptive awareness) were associated with changes in EWB outcomes, standardized residuals reflecting relative change were obtained by regressing post-treatment scores on baseline scores for all variables. Then, partial correlations (controlling for gender, age and site) between the standardized residuals for changes in mechanisms and changes in EWB were examined. To examine a potential dose effect, partial correlations between average weekly practice and change in both mechanisms and three EWB outcomes were conducted, controlling for home-practice randomization group, gender, age, and study site.</div></div><div><h3>Results</h3><div>Over the course of the intervention (T1 to T3), changes in self-compassion were associated with changes in both meaning and peace (<em>r</em>s = 0.52, 0.54, respectively, <em>ps</em> < 0.001), but not with changes in ability to pursue goals (<em>r</em> = 0.15, <em>p</em> = .21). Over the course of the intervention (T1 to T3), changes in the interoceptive awareness subscale of trusting were associated with changes in peace (<em>r</em> = 0.35, <em>p=</em>.003) and changes in the attention regulation subscale were associated with changes in both meaning (<em>r</em> = 0.37, <em>p</em> = .001) and peace (<em>r</em> = 0.34, <em>p</em>=.003). Yoga dosage was associated with increases in self-compassion (<em>r</em> = 0.34, <em>p</em> = .04) only.</div></div><div><h3>Conclusions</h3><div>Findings provide promising preliminary evidence that yoga interventions and community classes may benefit from emphasizing self-compassion and body a
{"title":"Self-compassion and interoceptive awareness as mechanisms of change in yoga for emotional well-being: A secondary analysis of a randomized controlled trial","authors":"Camille L. Garnsey , Katherine E. Gnall , Joshua A. Wilt , Crystal L. Park , Sara Lazar","doi":"10.1016/j.eujim.2026.102619","DOIUrl":"10.1016/j.eujim.2026.102619","url":null,"abstract":"<div><h3>Introduction</h3><div>Yoga practice is associated with improved emotional well-being (EWB), but little is known about the mechanisms of yoga that support EWB This post-hoc secondary analysis of a randomized controlled trial tested a) whether changes in self-compassion and interoceptive awareness were associated with changes in EWB (i.e., meaning in life, sense of inner peace, ability to pursue goals) over the course of a yoga intervention, and b) whether amount practiced relates to changes in proposed mechanisms and EWB outcomes.</div></div><div><h3>Methods</h3><div>Eighty-four participants who self-identified as stressed were randomized to varying doses of a 12-week Kripalu-style yoga intervention. As part of the parent clinical trial, participants completed self-report surveys at baseline, mid-treatment, and post-treatment assessing self-compassion (Self-Compassion Scale, Short Form), elements of interoceptive awareness (The Multidimensional Assessment of Interoceptive Awareness) and domains of emotional well-being (peace, meaning, ability to pursue goals; Functional Assessment of Chronic Illness Therapy–Spiritual Well-being Scale; Brief Self Control Scale). Seventy-five participants from the parent study had data for at least one of the main study variables and were thus included in this secondary analysis. To examine whether changes in hypothesized mechanisms (self-compassion, interoceptive awareness) were associated with changes in EWB outcomes, standardized residuals reflecting relative change were obtained by regressing post-treatment scores on baseline scores for all variables. Then, partial correlations (controlling for gender, age and site) between the standardized residuals for changes in mechanisms and changes in EWB were examined. To examine a potential dose effect, partial correlations between average weekly practice and change in both mechanisms and three EWB outcomes were conducted, controlling for home-practice randomization group, gender, age, and study site.</div></div><div><h3>Results</h3><div>Over the course of the intervention (T1 to T3), changes in self-compassion were associated with changes in both meaning and peace (<em>r</em>s = 0.52, 0.54, respectively, <em>ps</em> < 0.001), but not with changes in ability to pursue goals (<em>r</em> = 0.15, <em>p</em> = .21). Over the course of the intervention (T1 to T3), changes in the interoceptive awareness subscale of trusting were associated with changes in peace (<em>r</em> = 0.35, <em>p=</em>.003) and changes in the attention regulation subscale were associated with changes in both meaning (<em>r</em> = 0.37, <em>p</em> = .001) and peace (<em>r</em> = 0.34, <em>p</em>=.003). Yoga dosage was associated with increases in self-compassion (<em>r</em> = 0.34, <em>p</em> = .04) only.</div></div><div><h3>Conclusions</h3><div>Findings provide promising preliminary evidence that yoga interventions and community classes may benefit from emphasizing self-compassion and body a","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"82 ","pages":"Article 102619"},"PeriodicalIF":1.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146074477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2026-01-02DOI: 10.1016/j.eujim.2025.102607
Dilara Özturk , Gülcan Bahcecioglu Turan
Introduction
Yoga may support symptom management in individuals with Multiple Sclerosis (MS) by improving sleep, reducing fatigue, and promoting physical activity. This study examined the effects of a six-week yoga program on sleep quality, fatigue, and physical activity levels in patients with MS.
Methods
This randomized controlled trial included 60 patients with MS (30 intervention, 30 control). The intervention group completed 12 yoga sessions over six weeks, while the control group received no intervention. Sleep quality, fatigue, and physical activity were assessed using the Pittsburgh sleep quality index (PSQI), Fatigue severity scale (FSS), and international physical activity questionnaire–short form (IPAQ-SF).
Results
Compared with the control group, the intervention group showed substantial improvements in sleep quality (mean difference −6.14, 95% CI −7.79 to −4.49). Fatigue severity was lower in the yoga group after the intervention (mean difference −1.48, 95% CI −2.44 to −0.52). Physical activity levels increased markedly in the intervention group (mean difference +1857.92 met-min/week, 95% CI 1355.7 to 2360.1). No adverse effects related to the yoga intervention were reported.
Conclusion
A six-week yoga program improved sleep quality, reduced fatigue, and significantly increased physical activity levels in individuals with MS. Yoga may be considered a beneficial complementary approach in the care and symptom management of patients with MS.
{"title":"Effects of yoga on sleep quality, fatigue and physical activity levels in patients with multiple sclerosis: A randomized controlled trial","authors":"Dilara Özturk , Gülcan Bahcecioglu Turan","doi":"10.1016/j.eujim.2025.102607","DOIUrl":"10.1016/j.eujim.2025.102607","url":null,"abstract":"<div><h3>Introduction</h3><div>Yoga may support symptom management in individuals with Multiple Sclerosis (MS) by improving sleep, reducing fatigue, and promoting physical activity. This study examined the effects of a six-week yoga program on sleep quality, fatigue, and physical activity levels in patients with MS.</div></div><div><h3>Methods</h3><div>This randomized controlled trial included 60 patients with MS (30 intervention, 30 control). The intervention group completed 12 yoga sessions over six weeks, while the control group received no intervention. Sleep quality, fatigue, and physical activity were assessed using the Pittsburgh sleep quality index (PSQI), Fatigue severity scale (FSS), and international physical activity questionnaire–short form (IPAQ-SF).</div></div><div><h3>Results</h3><div>Compared with the control group, the intervention group showed substantial improvements in sleep quality (mean difference −6.14, 95% CI −7.79 to −4.49). Fatigue severity was lower in the yoga group after the intervention (mean difference −1.48, 95% CI −2.44 to −0.52). Physical activity levels increased markedly in the intervention group (mean difference +1857.92 met-min/week, 95% CI 1355.7 to 2360.1). No adverse effects related to the yoga intervention were reported.</div></div><div><h3>Conclusion</h3><div>A six-week yoga program improved sleep quality, reduced fatigue, and significantly increased physical activity levels in individuals with MS. Yoga may be considered a beneficial complementary approach in the care and symptom management of patients with MS.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"82 ","pages":"Article 102607"},"PeriodicalIF":1.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145908827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2026-01-20DOI: 10.1016/j.eujim.2026.102618
Qiuyun Xue , Lixia Yuan , Jieyi Zhou , Wenxi Li , Hui Wang , Zijie Hong , Xu Zhou
Introduction
To develop a core outcome set (COS) for clinical research on traditional Chinese dietotherapy for type 2 diabetes (T2D).
Methods
We conducted a systematic search of nine literature databases for randomized controlled trials (RCTs) on traditional Chinese dietotherapy or herbal medicine for T2D published between 2020 and 2022, from which outcomes and effect estimates were extracted. This was supplemented with semi-structured interviews with clinicians and patients/family members to form a candidate outcome pool. A Delphi expert survey was then employed to evaluate the importance of each outcome. Finally, a consensus meeting was held to establish the COS.
Results
The systematic literature review included 94 RCTs and 5 trial registration protocols, yielding 233 outcomes. Semi-structured interviews supplemented this with 8 additional outcomes. After cleaning, merging, and refining, 115 outcomes were excluded, resulting in a final candidate pool of 126 outcomes. These were categorized by functional attribute into a hierarchical framework comprising four primary domains: efficacy, safety, cost, and compliance. In the subsequent Delphi survey, the first round invited 40 experts, with 32 participating (response rate 80.0%); the expert authority coefficient was 0.732. Among 73 outcomes with importance scores below 85 or a coefficient of variation greater than 0.2, 72 were excluded by consensus meeting vote, one was retained, and 6 clinician-suggested outcomes were added, resulting in 60 outcomes proceeding to the second round. The second Delphi round invited 29 experts (response rate 90.6%), and the authority coefficient increased to 0.767. From 31 outcomes considered for exclusion in this round, 28 were ultimately excluded, and 3 were retained after the consensus meeting vote. The final consensus meeting established the Core Outcome Set for traditional Chinese dietotherapy in T2D (COS-TCD-T2D), which includes 32 outcomes categorized into four primary domains: efficacy (22 outcomes, further divided into 10 subdomains), safety (6 outcomes), cost (2 outcomes), and compliance (2 outcomes).
Conclusion
This study successfully developed the COS-TCD-T2D, which consists of 32 outcomes. It can serve as a standardized tool for outcome selection in clinical research on traditional Chinese dietotherapy and may also be applicable to other complementary treatments for T2D.
{"title":"Development of a core outcome set for traditional Chinese dietotherapy in type 2 diabetes","authors":"Qiuyun Xue , Lixia Yuan , Jieyi Zhou , Wenxi Li , Hui Wang , Zijie Hong , Xu Zhou","doi":"10.1016/j.eujim.2026.102618","DOIUrl":"10.1016/j.eujim.2026.102618","url":null,"abstract":"<div><h3>Introduction</h3><div>To develop a core outcome set (COS) for clinical research on traditional Chinese dietotherapy for type 2 diabetes (T2D).</div></div><div><h3>Methods</h3><div>We conducted a systematic search of nine literature databases for randomized controlled trials (RCTs) on traditional Chinese dietotherapy or herbal medicine for T2D published between 2020 and 2022, from which outcomes and effect estimates were extracted. This was supplemented with semi-structured interviews with clinicians and patients/family members to form a candidate outcome pool. A Delphi expert survey was then employed to evaluate the importance of each outcome. Finally, a consensus meeting was held to establish the COS.</div></div><div><h3>Results</h3><div>The systematic literature review included 94 RCTs and 5 trial registration protocols, yielding 233 outcomes. Semi-structured interviews supplemented this with 8 additional outcomes. After cleaning, merging, and refining, 115 outcomes were excluded, resulting in a final candidate pool of 126 outcomes. These were categorized by functional attribute into a hierarchical framework comprising four primary domains: efficacy, safety, cost, and compliance. In the subsequent Delphi survey, the first round invited 40 experts, with 32 participating (response rate 80.0%); the expert authority coefficient was 0.732. Among 73 outcomes with importance scores below 85 or a coefficient of variation greater than 0.2, 72 were excluded by consensus meeting vote, one was retained, and 6 clinician-suggested outcomes were added, resulting in 60 outcomes proceeding to the second round. The second Delphi round invited 29 experts (response rate 90.6%), and the authority coefficient increased to 0.767. From 31 outcomes considered for exclusion in this round, 28 were ultimately excluded, and 3 were retained after the consensus meeting vote. The final consensus meeting established the Core Outcome Set for traditional Chinese dietotherapy in T2D (COS-TCD-T2D), which includes 32 outcomes categorized into four primary domains: efficacy (22 outcomes, further divided into 10 subdomains), safety (6 outcomes), cost (2 outcomes), and compliance (2 outcomes).</div></div><div><h3>Conclusion</h3><div>This study successfully developed the COS-TCD-T2D, which consists of 32 outcomes. It can serve as a standardized tool for outcome selection in clinical research on traditional Chinese dietotherapy and may also be applicable to other complementary treatments for T2D.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"82 ","pages":"Article 102618"},"PeriodicalIF":1.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146074476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2026-01-01DOI: 10.1016/j.eujim.2025.102605
Debasis Behera , Prem Venkatesan , Mark P Jensen , Dharmanand Balebail Gopalakrishna , Abhishek Patil , Vani Lakshmi R
Introduction
Chronic low back pain (CLBP) is among the most prevalent musculoskeletal disorders that significantly affects the quality of life of those with this condition. Clinical hypnosis is a psychological intervention that can be used to reduce the intensity and impact of chronic pain. Systematic reviews and meta-analyses have concluded that clinical hypnosis is effective for general chronic pain conditions; however, meta-analytic research on its impact specifically on CLBP remains scarce. This study protocol describes a systematic review and meta-analysis aimed at evaluating the efficacy of hypnosis in reducing pain and associated symptoms in individuals with CLBP, as investigated in randomized controlled trials (RCTs).
Methodology
The review will be conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. A comprehensive search of eight electronic databases (Scopus, PubMed, CINAHL, Cochrane Central Register of Controlled Trials, EMBASE, PEDro, ScieELO, and LILACS) will be conducted to retrieve relevant studies published up to the date that we conduct the primary analyses, and then repeated just before we submit the article (with any additional articles identified incorporated into the review). Studies with RCTs, involving adults with CLBP (≥3 months), where hypnosis intervention was used as monotherapy or an adjunct therapy, will be eligible for inclusion. The primary outcome will be pain intensity, while secondary outcomes will include disability, sleep disturbances, and adverse events. Selection of studies, extraction of relevant data, and assessing risk of bias using Cochrane risk of bias tool-2 will be performed by two independent reviewers. Any discrepancies will be addressed through mutual discussion or by consulting a third independent reviewer if required. Meta-analysis will be performed using standardized mean differences for pain and secondary outcomes. Heterogeneity will be assessed and subgroup analyses are planned.
Conclusion
The review will provide an extensive overview of the available evidence on the efficacy of hypnosis on individuals with CLBP and identify knowledge. The results are intended to support the development of clinical recommendations and assist healthcare providers who are considering incorporating clinical hypnosis into interdisciplinary pain management strategies.
Trial Registration
PROSPERO 2025 CRD420251016398 on 29th March 2025.
慢性腰痛（CLBP）是最常见的肌肉骨骼疾病之一，严重影响患者的生活质量。临床催眠是一种心理干预，可用于减少慢性疼痛的强度和影响。系统综述和荟萃分析得出结论，临床催眠对一般慢性疼痛状况有效；然而，关于其对CLBP影响的meta分析研究仍然很少。本研究方案描述了一项系统综述和荟萃分析，旨在评估催眠在减轻CLBP患者疼痛和相关症状方面的疗效，该研究在随机对照试验（RCTs）中进行了调查。评价将按照系统评价和荟萃分析指南的首选报告项目进行。我们将对8个电子数据库（Scopus、PubMed、CINAHL、Cochrane Central Register of Controlled Trials、EMBASE、PEDro、ScieELO和LILACS）进行全面检索，检索到我们进行初步分析的日期之前发表的相关研究，然后在我们提交文章之前进行重复检索（任何确定纳入综述的其他文章）。涉及CLBP成人（≥3个月）的随机对照试验，其中催眠干预作为单一治疗或辅助治疗，将符合纳入条件。主要结局是疼痛强度，次要结局包括残疾、睡眠障碍和不良事件。研究的选择、相关数据的提取以及使用Cochrane风险偏倚工具-2评估偏倚风险将由两位独立的审稿人完成。任何差异将通过相互讨论或咨询第三方独立审查员（如有必要）来解决。将使用疼痛和次要结局的标准化平均差异进行meta分析。将评估异质性并计划进行亚组分析。结论：本综述将对催眠对CLBP患者的有效性和识别知识的现有证据进行广泛的概述。研究结果旨在支持临床建议的发展，并协助正在考虑将临床催眠纳入跨学科疼痛管理策略的医疗保健提供者。试验注册号prospero 2025 CRD420251016398，于2025年3月29日。
{"title":"The efficacy of hypnosis in chronic low back pain: Protocol for a systematic review and meta-analysis of randomized controlled trials","authors":"Debasis Behera , Prem Venkatesan , Mark P Jensen , Dharmanand Balebail Gopalakrishna , Abhishek Patil , Vani Lakshmi R","doi":"10.1016/j.eujim.2025.102605","DOIUrl":"10.1016/j.eujim.2025.102605","url":null,"abstract":"<div><h3>Introduction</h3><div>Chronic low back pain (CLBP) is among the most prevalent musculoskeletal disorders that significantly affects the quality of life of those with this condition. Clinical hypnosis is a psychological intervention that can be used to reduce the intensity and impact of chronic pain. Systematic reviews and meta-analyses have concluded that clinical hypnosis is effective for general chronic pain conditions; however, meta-analytic research on its impact specifically on CLBP remains scarce. This study protocol describes a systematic review and meta-analysis aimed at evaluating the efficacy of hypnosis in reducing pain and associated symptoms in individuals with CLBP, as investigated in randomized controlled trials (RCTs).</div></div><div><h3>Methodology</h3><div>The review will be conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. A comprehensive search of eight electronic databases (Scopus, PubMed, CINAHL, Cochrane Central Register of Controlled Trials, EMBASE, PEDro, ScieELO, and LILACS) will be conducted to retrieve relevant studies published up to the date that we conduct the primary analyses, and then repeated just before we submit the article (with any additional articles identified incorporated into the review). Studies with RCTs, involving adults with CLBP (≥3 months), where hypnosis intervention was used as monotherapy or an adjunct therapy, will be eligible for inclusion. The primary outcome will be pain intensity, while secondary outcomes will include disability, sleep disturbances, and adverse events. Selection of studies, extraction of relevant data, and assessing risk of bias using Cochrane risk of bias tool-2 will be performed by two independent reviewers. Any discrepancies will be addressed through mutual discussion or by consulting a third independent reviewer if required. Meta-analysis will be performed using standardized mean differences for pain and secondary outcomes. Heterogeneity will be assessed and subgroup analyses are planned.</div></div><div><h3>Conclusion</h3><div>The review will provide an extensive overview of the available evidence on the efficacy of hypnosis on individuals with CLBP and identify knowledge. The results are intended to support the development of clinical recommendations and assist healthcare providers who are considering incorporating clinical hypnosis into interdisciplinary pain management strategies.</div></div><div><h3>Trial Registration</h3><div>PROSPERO 2025 CRD420251016398 on 29th March 2025.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"82 ","pages":"Article 102605"},"PeriodicalIF":1.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2025-12-20DOI: 10.1016/j.eujim.2025.102604
Tina Stone , Alison Short , Caroline Smith
Introduction
Cognitive impairment associated with schizophrenia is persistent and can lead to functional disability and a reduced quality of life. Although cognitive remediation is recommended in clinical guidelines, access in Australia remains inconsistent, and implementation and participation barriers limit its effectiveness. Cognitively stimulating activities, particularly music therapy, could offer an alternative approach, although limited research has examined its feasibility within Australian mental health services. This exploratory mixed-methods survey aimed to understand mental health clinicians’ perspectives on: (1) the cognitive health interventions available within their services, (2) the challenges and facilitators involved in implementing these interventions, and (3) the potential for using music therapy as a cognitively stimulating activity for adults with schizophrenia.
Methods
A mixed methods purpose-designed online survey was conducted across six months with qualified mental health clinicians in Australia. Snowball sampling was utilised for recruitment. Quantitative data were analysed with descriptive statistics, and qualitative responses underwent a five-stage reflexive thematic analysis. Both types of data were analysed simultaneously using an integrated approach.
Results
A total of 37 clinicians completed the survey. More than half of respondents (56.7 %) reported that cognitive remediation programs were available at their mental health service, while 89.3 % noted the availability of cognitively stimulating activities. The main implementation challenges reported were discharge timing, lack of training, staffing issues, insufficient resources, and difficulties engaging consumers. Enablers included applying evidence-based practice, personalising interventions, and prioritising recovery goals. Participants viewed music therapy as helpful for improving attention, memory, and communication.
Conclusion
The findings of this study show that clinicians value cognitive health interventions for schizophrenia but face significant implementation challenges, particularly a lack of training, insufficient resources, and staffing constraints. Music therapy is seen as a promising cognitively stimulating activity that may help overcome accessibility, engagement, and resource barriers. Further research is necessary to assess the feasibility of using music therapy to support adults with schizophrenia in improving their cognitive skills.
{"title":"Implementation of cognitive health interventions for schizophrenia: A survey of mental health clinicians’ perceived challenges and enablers","authors":"Tina Stone , Alison Short , Caroline Smith","doi":"10.1016/j.eujim.2025.102604","DOIUrl":"10.1016/j.eujim.2025.102604","url":null,"abstract":"<div><h3>Introduction</h3><div>Cognitive impairment associated with schizophrenia is persistent and can lead to functional disability and a reduced quality of life. Although cognitive remediation is recommended in clinical guidelines, access in Australia remains inconsistent, and implementation and participation barriers limit its effectiveness. Cognitively stimulating activities, particularly music therapy, could offer an alternative approach, although limited research has examined its feasibility within Australian mental health services. This exploratory mixed-methods survey aimed to understand mental health clinicians’ perspectives on: (1) the cognitive health interventions available within their services, (2) the challenges and facilitators involved in implementing these interventions, and (3) the potential for using music therapy as a cognitively stimulating activity for adults with schizophrenia.</div></div><div><h3>Methods</h3><div>A mixed methods purpose-designed online survey was conducted across six months with qualified mental health clinicians in Australia. Snowball sampling was utilised for recruitment. Quantitative data were analysed with descriptive statistics, and qualitative responses underwent a five-stage reflexive thematic analysis. Both types of data were analysed simultaneously using an integrated approach.</div></div><div><h3>Results</h3><div>A total of 37 clinicians completed the survey. More than half of respondents (56.7 %) reported that cognitive remediation programs were available at their mental health service, while 89.3 % noted the availability of cognitively stimulating activities. The main implementation challenges reported were discharge timing, lack of training, staffing issues, insufficient resources, and difficulties engaging consumers. Enablers included applying evidence-based practice, personalising interventions, and prioritising recovery goals. Participants viewed music therapy as helpful for improving attention, memory, and communication.</div></div><div><h3>Conclusion</h3><div>The findings of this study show that clinicians value cognitive health interventions for schizophrenia but face significant implementation challenges, particularly a lack of training, insufficient resources, and staffing constraints. Music therapy is seen as a promising cognitively stimulating activity that may help overcome accessibility, engagement, and resource barriers. Further research is necessary to assess the feasibility of using music therapy to support adults with schizophrenia in improving their cognitive skills.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"82 ","pages":"Article 102604"},"PeriodicalIF":1.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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