Journal of Integrative and Complementary Medicine最新文献

Introduction: Survivors from racially and ethnically diverse backgrounds tend to experience cancer-related fatigue (CRF) at higher rates than non-Hispanic Whites (NHWs), often leading to a decline in quality of life (QOL). It is crucial to consider the impact their marginalized identities have on cancer outcomes. Although yoga has shown promise as a supportive intervention for CRF and QOL, existing research has largely centered on NHW populations. This study seeks to evaluate the impact of yoga on CRF and QOL among racially and ethnically diverse survivors and compare outcomes with NHW survivors. Methods: This study used data from two randomized controlled trials (RCTs; n = 1,153) examining a 4-week Yoga for Cancer Survivors (YOCAS) intervention designed to address insomnia in survivors. YOCAS integrates elements of gentle Hatha and Restorative Yoga, featuring breathing techniques, mindful movement, and posture alignment, for 150 min each week for 4 weeks. Survivors were eligible if they (1) were age 21+, (2) were randomized to YOCAS^©®, (3) identified as Hispanic or a non-Hispanic person of color, and (4) provided evaluable data on the Functional Assessment for Chronic Illness Therapy-Fatigue and Functional Assessment for Cancer Therapy-General at pre- and postintervention. Results: Forty-nine participants were eligible (mean age = 53; 96% female; 79% stage 0-II cancer; 74% breast cancer). Participants reported nonclinically meaningful improvements in overall CRF improvement (1.55, standard deviation [SD] = 14.67, p < 0.061), total QOL (3.04, SD = 0.055, p < 0.055), the emotional component of QOL (0.85, SD = 6.3, p < 0.061), and significant improvements in the physical component of QOL (1.32, SD = 7.0, p < 0.035). Session attendance averaged six out of eight sessions. Participants also engaged in an additional self-guided yoga practice at home each week. Most (86%) participants expressed that the program was beneficial in managing symptoms and indicated they would suggest it to survivors. Discussion: Findings suggest: (1) YOCAS^©® has the potential to alleviate fatigue and enhance QOL in racially and ethnically diverse survivors; (2) while participation rates remain modest, there is openness to yoga; and (3) diverse survivors are capable of completing a 4-week yoga program, report it as useful for controlling symptoms, and are likely to suggest it to survivors. Future research should include well-powered RCTs to verify YOCAS^©®'s effects on CRF and QOL in these populations.

Introduction: This scoping review evaluated the efficacy/effectiveness and utilization of complementary and integrative health (CIH) therapies for pain management within the Military Health System (MHS). Specifically, it aimed to assess evidence-based modalities such as acupuncture, biofeedback, hypnosis, massage therapy, meditation, guided imagery, Tai Chi/Qi Gong, and yoga, which are part of the Veterans Administration's (VA) Whole Health program. The goal was to determine their effectiveness in military service members and understand their utilization in the MHS, as well as explore CIH research in the MHS to identify gaps. Methods: A comprehensive search of PubMed, Embase, and Ovid All EBM Reviews databases was conducted for studies published from January 1, 2014 to March 22, 2024. The search focused on CIH therapies related to pain management in military populations, yielding 433 studies. After screening for eligibility, 53 studies were included for detailed review. Studies included randomized controlled trials, case studies, large database analyses, and retrospective chart reviews. Exclusion criteria eliminated nonpeer-reviewed articles, not pain-related, not related to one of the prespecified CIH modalities (acupuncture, biofeedback, hypnosis, massage therapy, meditation, guided imagery, Tai Chi/Qi Gong, and yoga), and those not specific to the MHS. The review did not address bias due to the heterogeneity of study designs included. Results: The review identified significant evidence supporting the use of CIH modalities for pain management. Acupuncture, particularly Battlefield Acupuncture, showed immediate reduction in pain score for both acute and chronic pain. Studies of massage therapy and biofeedback demonstrated efficacy/effectiveness in reducing pain and improving functional outcomes in various musculoskeletal and stress-related disorders. Meditation and yoga were shown to be effective for chronic pain, stress management, and enhancing overall well-being. Utilization data indicated a steady increase in CIH therapy use across military facilities. Discussion: CIH therapies, particularly acupuncture, massage therapy, and yoga, appear to be effective nonpharmacologic interventions for pain management in military populations. Their growing utilization reflects the recognition of their benefits in managing chronic pain and improving quality of life among service members. Further research is needed to standardize practices and optimize utilization across the MHS. Registration of Protocol: PROSPERO 2024 CRD4202453685, 29 April 2024, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024536853.

Objective: To review proposed Whole Person Health (WPH) domains and existing WPH measurement instruments. Introduction: WPH clearly involves multiple domains (e.g., physical, mental, spiritual). To date, however, there is little consensus on which domains should be included in WPH, and WPH as an outcome is often conflated with WPH determinants (i.e., whole-person care). We conducted a scoping review of conceptual domains and existing WPH measurement instruments. Eligibility Criteria: Peer-reviewed articles and gray literature published from January 2014 to December 2023 that included a theoretical model or empirical measure of self-reported "whole person health" were reviewed. Theoretical/conceptual sources and empirical studies with observational or intervention study designs, including adults 18 or older, were eligible for inclusion. Studies focusing on pediatric populations, educational and personality constructs, and whole health systems of care without mentioning WPH were excluded. Methods: We searched five databases (PubMed, CINAHL, PsycINFO, ERIC, and Web of Science) and Google Scholar for peer-reviewed articles and gray literature published in English. Two research team members screened articles and extracted study characteristics. Results describe WPH conceptual domains, published self-report measures, and their psychometric properties. Results: Our search identified 1143 unique sources, with 29 deemed eligible for review. Eleven conceptual articles mentioned four to six of seven total WPH domains each: biological/physical, behavioral/mental, social, environmental, spiritual, socioeconomic, and individual/other. Our search identified six WPH measures. All six WPH measures included assessments of the biological/physical, behavioral/mental, social, and spiritual domains, and all the conceptual WPH domains were assessed by at least one self-report measure. The self-report measures had a stronger emphasis on the assessment of spirituality and individual domains relative to the conceptual models and were less likely to include assessments of environmental and socioeconomic domains. Conclusions: The results of this scoping review provide a greater understanding of the domains involved in WPH as a multidimensional construct. Although no existing WPH measures are suitable for broad use, their structural commonalities imply that WPH measure development efforts should consider the assessment of physical, mental, social, spiritual, and individual domains.

Background: Building on the 2017 Compendium of Health and Wellness Coaching (HWC) and its 2019 Addendum, the 2023 Addendum extends the scope of research by incorporating studies published from 2018 to 2022. This latest version continues to serve as a vital resource for practitioners and researchers, offering access to a comprehensive collection of studies spanning established and emerging health domains. Methods: The 2023 Addendum updates and expands the evidence base to evaluate HWC's effectiveness across various conditions and settings. In this iteration, an expanded range of literature databases was explored to ensure inclusivity, categorizing articles into eight established health conditions-such as diabetes, heart disease, and obesity-while introducing two new categories reflecting research trends in respiratory conditions and chronic pain management. Results: The addendum includes findings from 212 articles, among which 115 randomized controlled trials (RCTs) demonstrate the effectiveness of HWC in improving patient-centered outcomes such as chronic care management, medication adherence, self-efficacy, and quality of life. Positive impacts were also documented on surrogate biomarkers, particularly in diabetes, hypertension, and cardiovascular care. All articles, including reviews and commentaries, are indexed with detailed methodologies and findings in an accessible spreadsheet format. Conclusions: Since its first iteration in 2017, the Compendium has grown to encompass over 480 articles, including more than 140 RCTs, illustrating the expanding role of HWC in health care. This evidence base underscores HWC's utility as a key intervention for chronic disease management, preventive care, and whole-person health. Future research should focus on refining coaching methodologies, evaluating long-term outcomes, and exploring cost-effectiveness to enhance HWC's delivery and impact across diverse populations and settings.

Background and Aim: Cardiovascular diseases (CVDs), the leading cause of sudden death, are primarily driven by metabolic dysfunction, a core mechanism underlying their onset and progression. Emerging research suggests that Tai Chi, an ancient martial art, positively impacts metabolic health. Accordingly, we sought to conduct a systematic review to examine clinical evidence regarding the effectiveness and safety of Tai Chi in managing cardiometabolic risk factors (CRFs). Methods and Results: A comprehensive literature search of eight electronic databases identified randomized controlled trials (RCTs) that met predefined inclusion criteria, focusing on adults with CRFs such as obesity, hyperlipidemia, hypertension, and glycemic dysregulation. Interventions involving Tai Chi were compared with nonexercise controls or other exercise modalities. Outcomes included lipid profiles, blood pressure, blood glucose, body composition, and adverse events. Results: Thirteen RCTs involving 1746 participants were included. Tai Chi significantly reduced triglycerides (TG) (mean difference [MD] = -0.20, p < 0.0001), fasting blood glucose (MD = -0.36, p = 0.025), DBP (MD = -4.49, p = 0.010), and waist circumference (MD = -3.34, p = 0.0001), while increasing high-density lipoprotein cholesterol (MD = 0.09, p < 0.0001) compared with nonexercise interventions. Compared with other exercises, Tai Chi reduced total cholesterol (MD = -0.33, p = 0.007) and TG (MD = -0.14, p = 0.0056). The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) assessment indicated the overall quality of evidence supporting these findings was moderate. No serious adverse events were reported. Conclusion: Tai Chi is an effective and safe exercise intervention for managing CRFs, especially for populations unable to engage in high-intensity exercise. While Tai Chi demonstrates modest efficacy compared with other exercises, its safety and accessibility make it a valuable option in clinical practice. Further high-quality studies are needed to confirm long-term effects and optimize intervention strategies.