Journal of Integrative and Complementary Medicine最新文献

Introduction: The Mindfulness-Based Stress Reduction program for breast cancer survivors (MBSR [BCs]) is a stress-reducing program designed to increase cognitive functioning through four meditational practices. This randomized clinical trial aimed to determine if improvements in cognitive functioning and perceived cognitive abilities achieved from the MBSR(BC) were mediated through increased mindfulness, decreased rumination, and decreased perceived stress. Methods: Breast cancer survivors (BCSs) who met inclusion criteria of stage I, II, or III BC and received either chemotherapy (CT) or both CT and radiation were randomized to either the 6-week MBSR(BC), or Breast Cancer Education Support (BCES) program, or to a usual care (UC) regimen. Analysis of covariance was first implemented to identify potential mediators, followed by a formal mediational analysis to evaluate the effects of MBSR(BC) on 6-, 12-, and 26-week outcomes. Results: After consent, 212 BCS were randomized to MBSR(BC) (n = 91), BCES (n = 90), or UC (n = 31). The mean age was 56.5 and the majority of the BCS, 73.1%, were White and non-Hispanic. Results showed increases in "observing" as part of mindfulness as a potential mediator of MBSR(BC) effects on impairments on quality of life and logical memory at 6 months relative to UC. No mediation effects were identified for outcomes measured at 6 or 12 weeks and also when MBSR(BC) was compared with the BCES program. Discussion: These results partially supported our hypothesis that improvement in cognitive functioning would occur through increased mindfulness. Although few mediating relationships were identified, results showed a relationship between mindfulness and cognitive functioning. Both mediating relationships occurred through increases in "observing," a subconcept of "mindfulness," when compared to the MBSR(BC) with UC at 6 months. This study shows that mediators may help "optimize" clinical therapeutic treatment effects, thus contributing to the advancement of science.

Trial registration: ClinicalTrials.gov, www.

Clinicaltrials: gov.

Registration number: NCT02786797.

Objective: The study was carried out to determine the effects of acupressure and massage on pain severity, menstrual symptoms, and quality of life in patients with primary dysmenorrhea. Materials and Methods: This randomized controlled trial was conducted between January 2021 and May 2021. The study initially enrolled 309 female students with primary dysmenorrhea studying at a university in the Central Anatolia Region of Türkiye. After exclusions (due to secondary dysmenorrhea diagnosis, study discontinuation, or drug use), the study was completed with a total of 267 students. The students were divided into three groups as follows: (1) the acupressure+massage group, (2) the massage-only group, and (3) the control group. Acupressure + massage and massage-only groups were timed for the first 3 days of three consecutive menstrual cycles. The primary outcome of the study was the mean pain score for primary dysmenorrhea. Data were collected with the Visual Analog Scale, Daily Menstrual Symptom Rating Scale, and Short Form 12 Health Survey. Results: In the first cycle and first day of preintervention measurement, the physical and mental health levels, which are the subscales of pain severity, menstrual symptom intensity, and quality of life, were similar in the three groups (p > 0.05). In other measurements during the three cycles, it was determined that the pain severity and menstrual symptom intensity in the acupressure + massage and massage-only group were lower than the control group (p < 0.05). After the intervention, it was determined that there was no significant difference in all subscales of the Quality of Life Scale (p > 0.05). In the acupressure + massage group, three participants reported having adverse reactions, including pain at the acupoints (n = 1) and shift in menstruation cycle (n = 2); in the massage-only group, four participants reported having adverse reactions, including redness (n = 3) and tingling in a finger (n = 1). Conclusion: It was determined that acupressure and massage applied to those with primary dysmenorrhea were effective methods to reduce the pain level and menstrual symptom intensity, but did not affect their quality of life. Clinical Trials Number: A Clinical trials number was received from ClinicalTrials.gov (NCT04942288).

Introduction: Primary dysmenorrhea (PD) is associated with decreased performance and reduced quality of life in young adults. This study aims to evaluate the effectiveness of implementing Arogya Rakshak Panchatantra (ARP), a naturopathic lifestyle practice, among young female adults with PD. Method: This open-label, parallel-arm, randomized controlled trial included 52 young female adults with PD aged between 16 and 25 years. They were randomly assigned to the ARP group practicing the ARP module for 2 months or the control group maintaining their routine lifestyle. The primary outcome was changes in heart rate variability (HRV), while secondary outcomes included menstrual distress, quality of life, pain, and daytime sleepiness, all evaluated at baseline and during the first three menstrual cycles in both groups. To evaluate the feasibility, the study also monitored self-reported symptoms, emotions, adverse events, calorie intake, and adherence to the intervention. The effectiveness of ARP was evaluated using repeated measures analysis of variance and a generalized linear model. Results: In the intervention group, we observed significant improvements in the high frequency component of HRV (p = 0.007), as well as reductions in weight (p = 0.017), visual analog scale pain (p = 0.000), and retrospective symptom scale score (p < 0.011). There were no significant changes in other HRV metrics, quality of life, or daytime sleepiness. Participants reported mild symptoms such as headaches, colds, body pain, diarrhea, constipation, fever, and weakness, with no serious adverse events. Discussion: This trial is the first to examine the long-term impact of ARP on young females with PD, suggesting it could be an effective and feasible management option. Further research with larger sample sizes is needed to confirm these findings.

Background: More cancer centers are offering integrative medicine (IM) therapies. However, it is unclear how many patients are aware of, and are utilizing, these therapies to help manage their symptoms. Objectives: This survey study examines patients' knowledge, satisfaction with, and perceptions of available IM resources at an academic cancer center. Methods: An online, anonymous survey was sent to 7,807 patients of the University of California Davis Health Comprehensive Cancer Center using the electronic health record. The survey consisted of 11 primary questions with follow-up questions. Results: One thousand and sixteen respondents initiated the survey (response rate of 13%). Eight hundred and fifty-five respondents (10.9%) completed the survey. Mean age was 65.4 years; 67.3% of respondents were female, 84.9% were Caucasian/White, and 86.8% reported being non-Hispanic. The largest group of responders were patients with breast cancer (25.7%). 78.7% reported no IM use, and 18.9% reported using IM. Although 53.7% of respondents were satisfied with the resources, 42.1% reported not being aware of any IM resources. Those who were unaware of resources were more likely to be female than male (47.8% vs. 30.5%) and non-Hispanic (42.3% vs. 31.2%). 48.7% wanted additional IM resources. Of those who wanted additional resources, 54.7% wanted nutritional counseling, 49.3% wanted manipulative and body-based methods, 44.4% wanted alternative medical systems, and 43.4% wanted counseling on herbs, dietary supplements, and cannabis. Discussion: Forty-two percent of participants were unaware of any IM resources at the institution and an even greater number, 48.7%, voiced a desire for additional IM resources. Conclusion: This is the first study in the United States at an academic comprehensive cancer center to examine patients' perceptions of available IM resources. Although some cancer centers offer a variety of IM resources, many patients may be missing out on potential symptom or quality-of-life benefits due to a lack of awareness of these resources.

Objective: Collaboration between complementary and integrative health (CIH) institutions and research-intensive (R1) institutions has been successfully undertaken in the United States, resulting in federally funded research projects, educational programs, and faculty development. The aim of this cross-sectional survey study was to explore the barriers and facilitators to establishing and maintaining such collaborative partnerships. Methods: A 32-question survey was sent to participants recruited through author contacts and resources, literature review, and database searches. Participants were required to be researchers and affiliates who attempted, completed, or had current collaborative endeavors involving CIH and R1 institutions. Data were collected in the research electronic data capture (REDCap) system and descriptive quantitative and qualitative data analysis was undertaken. Results: A total of 26 unique entries were included in the final data analysis; four of which were paired entries (one from an R1 institution and one from a CIH institution) to make up two dyad data collections. Eighty-one percent of the participants had senior leadership roles at CIH institutions representing five CIH disciplines-East Asian medicine (acupuncture and Traditional Chinese Medicine), chiropractic medicine, massage therapy, naturopathy, and yoga. Collaborative research projects were often (>38%) in response to specific project funding mechanisms. Over 60% of the collaborations also included educational activities and faculty development. Collaborations resulted in multiple different types of benefits to both institutions but were not without associated challenges. Conclusion: Collaborations between R1 and CIH institutions can be cooperative, productive, and mutually beneficial. Funding mechanisms supporting R1 and CIH collaboration increase CIH research productivity as well as the development of innovative research methodology to study the real-world practice of CIH therapies, whole systems, and whole person health. CIH researchers would greatly benefit from such funding, allowing access to research infrastructure, professional development, and the provision of protected time to conduct research.

Background: Mind-body practices (MBPs), which include seated- (meditation) and movement-based practices (yoga, Tai Chi, qigong), have grown increasingly popular in the United States for improving mental and physical wellness. While literature has identified socioeconomic and health-related factors related to seated- and movement-MBP engagement separately, no studies have explored the factors associated with combined-MBP use. This study accordingly used Anderson's behavioral model of health service utilization to explore sociodemographic and health-related factors associated with seated-, movement-, and combined-MBP engagement among a representative adult sample in the 2017 National Health Interview Survey. Methods: Descriptive statistics were used to summarize sample characteristics. Multinomial logistic regression using survey weights examined associations between predisposing (race-ethnicity, age, geographic region, sex, sexual minority status, and marital status), enabling (educational attainment, income, having continuous health insurance coverage, and having flexible spending accounts), and needs factors (psychological distress, self-reported health, and chronic pain) with type of MBP engagement. Results: Nearly 6% (5.8%) of the U.S. adult population practiced combined-MBPs. Results also showed that educational attainment was associated with increasingly higher odds of utilizing all forms of MBPs and revealed racial-ethnic disparities in movement- and combined-MBP engagement. Combined-MBP engagement was roughly two times higher among those with moderate psychological distress (relative risk ratio [RRR] = 1.92; 95% confidence interval [CI]: 1.58-2.32; p < 0.001), severe psychological distress (RRR = 1.96; 95% CI: 1.35-2.85; p < 0.001), and chronic pain. Conclusions and Implications: Findings suggest that combined-MBPs are utilized by a significant portion of the U.S. population and that engagement has varied distribution across sociodemographic and health factors. Considering the association of combined-MBP usage with mental and physical health needs, the authors recommend that health care providers suggest combined-MBPs as an additional resource for patients with psychological distress or mild chronic pain. Future practice and research can focus on increasing accessibility to MBPs in education settings to reduce racial-ethnic disparities.

Introduction: The increased use of dietary supplements is a consequence of the coronavirus disease 2019 (COVID-19) pandemic. Although their efficacy has not been consistently proven, they have been perceived as a preventive tool against COVID-19. Less strict regulations and debates on their definitions in a regulatory framework raise concerns about safety issues. Apart from dietary supplement use, information demand has increased, and pharmacists have played a key role as accessible health professionals. This study aimed to reveal the opinions of community pharmacists, pharmacy staff, sector representatives, and academicians regarding the sale and use of dietary supplements during the COVID-19 pandemic. Methods: A qualitative study approach was followed, using grounded theory. Data were collected between September 2021 and July 2022, analyzed using MAXQDA 2020 software, and reported according to the Consolidated Criteria for Reporting Qualitative Research. Results: After refining the open codes, two themes emerged: dietary supplements and the effects of the pandemic. It was found that increased dietary supplement use was rooted in COVID-19 fear, promotional activities, and social media influence. The interaction between consumers and the dietary supplement industry is bidirectional. Conclusions: Pharmacies, as access points for these products, played a crucial role in struggling with the effects of the pandemic. Although dietary supplements are considered safe, their potential for adverse reactions poses a public health risk. Flexible regulations, unregulated alternative advertising channels, and a lack of awareness of the safety of these products pose a challenge to public health. In this regard, all stakeholders should work to minimize the risks from undergraduate education to professional life.

Objectives: Chronic nonspecific neck pain (CNNP) is prevalent among health care workers, with particularly high rates among nurses. Nurses experiencing CNNP often report decreased job satisfaction, increased absenteeism, and reduced productivity. In recent years, nonpharmacologic approaches have gained attention as effective treatments for the management of CNNP, with exercise and manual therapies representing two of the most common. Early evidence shows that multimodal treatments may be more effective than unimodal strategies. The purpose of this current study was to assess the feasibility and observe the clinical outcomes of combined multimodal chiropractic care (MCC) and Tai Chi (TC) for CNNP in nurses. Methods: A single-arm mixed-methods pilot trial was conducted including 16 weeks of MCC and TC in nurses with self-reported CNNP. Feasibility outcomes were recruitment, retention, and adherence to the interventions. Clinical outcomes of interest included neck pain and related disabilities. Secondary outcomes of interest were functional, affective, and work-related performance. Qualitative interviews were also conducted. Results: Of the 59 screened, 36 met the eligibility criteria, and 21 were enrolled. The retention rate was 71.4%, and adherence rates were 85.3% for MCC and 62.5% for TC classes. Multiple pain and disability-related outcomes exhibited modest improvement from baseline to 16-week follow-up. Qualitative analysis identified six emergent themes: (1) neck pain being an inherent part of nursing, (2) nurses push through their pain, (3) MCC relieves pain and is instructive for preventing pain, (4) TC provides overall relaxation, (5) both interventions increased body awareness and improved posture, and (6) scheduling difficulties were a key obstacle for participating. Conclusions: Observed reductions in neck pain and disability suggest the potential utility of combined MCC and TC interventions for managing CNNP. Along with qualitative feedback regarding facilitators and barriers to participation, the findings support and inform a future randomized trial evaluating the combined benefits of MCC and TC for CNNP in nurses. Clinical Trial Registration #NCT06523036.

Objective: Binaural beats, or the perceptual auditory illusions created when simultaneously presenting two similar frequencies to each ear separately, have been used to reduce anxiety in various procedures. Unfortunately, no prior study involved preprocedure binaural music exposure among patients undergoing upper gastrointestinal endoscopy, and this study sought to investigate its effect on anxiety and tolerance among participants undergoing sedation-free upper gastrointestinal endoscopy. Methods: The prospective, controlled, randomized trial included the participation of 96 Turkish patients aged between 18 and 70 years who were scheduled for an upper gastrointestinal endoscopy, regardless of sex or illness, and were divided randomly into two different groups to undergo endoscopy, namely, the binaural beats group (n = 48) and a control group (n = 48). Patients in the binaural beat music group wore headphones, and music was given 15 mins before endoscopy; however, no particular treatment was given for either group. Anxiety levels were assessed by using the State Trait Anxiety Inventory questionnaire, in addition to changes before and after endoscopy to measure patient satisfaction based on the physician's recorded numbers of retches noted by doctors as tolerance was documented and compared among both groups. Results: The results showed that following this procedure, in the music group, state scores remained significantly lower than before them (p = 0.016), compared with the control group (p > 0.05). There was no significant difference regarding changes in diastolic or systolic heart rate or blood pressure (p > 0.05). However, the procedure tolerance and satisfaction scores were significantly higher in the music group than those without music (p < 0.05). Conclusion: For patients undergoing upper gastrointestinal endoscopy, music with binaural beats was found to significantly reduce anxiety levels and increase patient tolerance, providing an alternative option to sedative medications as a potential sedative treatment option.Clinical trials registration number: NCT06114524.