Complementary Therapies in Clinical Practice最新文献

Background

To examine the effectiveness of interventions to ameliorate burnout, secondary traumatic stress, and emotional exhaustion in nurses and midwives. The systematic review was completed with all available studies that reported data on the effect of interventions that targeted burnout using the outcome measures of the Professional Quality of Life scale (ProQOL), or the Maslach Burnout Inventory (MBI).

Methods

We used a systematic review methodology, which included a meta-analysis. A total of 2103 articles resulted from the systematic search; 688 were removed as duplicates, and 1415 articles were reviewed by the title and abstract, of which 255 were eligible for full-text screening. Only 66 met the inclusion criteria and were included in the analysis. The final meta-analysis consisted of 33 reports divided into 12 studies for ProQOL and 21 studies for the MBI.

Results

The results provide an overall effect in studies using the ProQOL measurement was Z = 2.07 (P = 0.04) and a positive improvement mean difference of 9.32. The overall effect in studies using MBI was Z = 3.13 (P = 0.002) and a positive improvement mean difference of 6.58.

Conclusions

Whilst most studies indicated a positive difference, the most effective interventions included clinical supervision or activities that addressed the personal physical and mental well-being of nurses. Less effective interventions were managerial interventions or ones that used a strictly educational approach.

Hypnosis is an ancient mind-body intervention that has regained interest with the surge of research in the last decade documenting its clinical validity. Yet, theoretical controversies and misconceptions prevail among theorists, clinicians, and the general public, impeding the understanding, acceptance, replication, and use of hypnosis. Providing adequate information, which dispels misconceptions and promotes more balanced views, is warranted to facilitate the implementation and adoption of hypnosis in clinical and research settings. This review re-examines the conceptualisation of hypnosis throughout history and the theoretical controversies surrounding it while highlighting their meeting points and clinical implications. Despite dichotomies, a broad agreement appears across theoretical approaches regarding hypnotic analgesia effects, key components, and vocabulary. Further, theories highlight key factors of hypnotic responding. For instance, social theories highlight social and contextual variables, whereas state theories highlight biopsychosocial mechanisms and individual factors. Based on theories, the terms hypnotherapy or clinical hypnosis are recommended to refer to the therapeutic use of hypnosis in psychotherapeutic and medical contexts, respectively. This review concludes with a model that integrates various theories and evidence and presents hypnosis as a complex multifaceted intervention encompassing multiple procedures, phenomena, and influencing factors. This review intends to deepen our understanding of hypnosis, and promote its more rapid adoption and adequate implementation in research and clinical contexts, in addition to steering research towards evidence-based hypnotic practice. The review can have important research and clinical implications by contributing to advancing knowledge regarding hypnotic procedures, phenomena, and influencing factors.

Purpose

This study aimed to investigate the relationship between physical fitness, gray matter volume (GMV), and autism severity in children with autism spectrum disorder (ASD). Besides, we sought to diagnose autism severity associated with physical fitness and GMV using machine learning methods.

Methods

Ninety children diagnosed with ASD underwent physical fitness tests, magnetic resonance imaging scans, and autism severity assessments. Diagnosis models were established using extreme gradient boosting (XGB), random forest (RF), support vector machine (SVM), and decision tree (DT) algorithms. Hyperparameters were optimized through the grid search cross-validation method. The shapley additive explanation (SHAP) method was employed to explain the diagnosis results.

Results

Our study revealed associations between muscular strength in physical fitness and GMV in specific brain regions (left paracentral lobule, bilateral thalamus, left inferior temporal gyrus, and cerebellar vermis I-II) with autism severity in children with ASD. The accuracy (95 % confidence interval) of the XGB, RF, SVM, and DT models were 77.9 % (77.3, 78.6 %), 72.4 % (71.7, 73.2 %), 71.9 % (71.1, 72.6 %), and 66.9 % (66.2, 67.7 %), respectively. SHAP analysis revealed that muscular strength and thalamic GMV significantly influenced the decision-making process of the XGB model.

Conclusion

Machine learning methods can effectively diagnose autism severity associated with physical fitness and GMV in children with ASD. In this respect, the XGB model demonstrated excellent performance across various indicators, suggesting its potential for diagnosing autism severity.

Background

The incidence of nausea and vomiting following craniotomy is high, and pericardium 6 (P6; Neiguan) acupoint stimulation is an important strategy for treating postoperative nausea and vomiting (PONV). Here, we aimed to evaluate the efficacy of transcutaneous electrical acupoint stimulation (TEAS) at P6 as an adjunct to antiemetic drugs to prevent PONV after craniotomy.

Materials and methods

This randomized placebo-controlled trial enrolled 120 patients scheduled for craniotomy. The enrolled patients were randomly assigned to a TEAS or sham TEAS group. The incidence of PONV, pain score, and postoperative remedial treatment with antiemetics and analgesics at 0–2, 2–6, and 6–24 h after craniotomy were assessed.

Results

The patient characteristics did not significantly differ between the two groups (P > 0.05). During 0–2 and 6–24 h after craniotomy, the incidence of vomiting was not significantly different between the two groups (P > 0.05). During 2–6 h, the incidence of vomiting was higher in the sham TEAS group than in the TEAS group (29.3 % vs. 14.0 %, P = 0.047). During 0–2 and 2–6 h, the pain scores did not differ significantly between the two groups (P > 0.05). During 6–24 h after craniotomy, the pain score was significantly higher in the sham TEAS group than in the TEAS group (P = 0.001). The degree of nausea and proportion of patients requiring antiemetic drugs were not significantly different between the two groups in each period (P > 0.05).

Conclusion

TEAS at P6 may reduce vomiting incidence and pain scores following craniotomy.

Purpose

Breast cancer (BC) patients commonly face stress that causes severe psychological and physiological problems. The main objective of the review was to confirm the effect of interventions on breast cancer patients’ perceived stress, and the secondary objective was to explore the impact of interventions on anxiety, depression, and inflammatory markers.

Methods

A systematic and comprehensive search for randomized controlled trials (RCTs) that reported interventions’ effects on perceived stress in breast cancer patients was performed in nine databases.

Results

Twenty-four RCTs, including 1887 participants, met the inclusion criteria, summarizing six categories for the intervention group: mindfulness and yoga, exercise, cognitive-behavioral stress management, self-regulation, relaxation training, and acupuncture. Compared with usual care or other types of care, mindfulness and yoga had excellent effects against perceived stress, anxiety, and depression; self-regulation could reduce perceived stress and anxiety; exercise could reduce perceived stress; acupuncture could reduce the level of depression; mindfulness could improve the TNF-α level, and yoga can reduce the level of salivary cortisol and DNA damage.

Conclusion

This systematic review indicated that nondrug interventions, such as mindfulness and yoga, effectively reduce perceived stress, anxiety, and depression. Rigorous studies with large sample sizes are needed to address the limitations of small sample sizes and shortcomings in methodology in this area.

The role of the patient in hypnotherapy can be underestimated by both the therapist and the patient. This is likely due to the focus the hypnosis literature has had on the role played by the hypnotist/therapist and less on the phenomenological control (control over subjective experience) applied by the patient. Whilst early approaches to hypnosis and hypnotherapy included concepts such as autosuggestion and self-hypnosis, the role of the self has been largely overlooked. Here we aim to highlight the importance of the self in hypnotherapy and hypnosis by considering the concept of self-hypnosis and how it relates to hetero-hypnosis. We will show that: 1) historically the self was an important component of the concept of hypnosis; 2) extant theories emphasise the role of the self in hypnosis; 3) self-hypnosis is largely indistinguishable from hetero-hypnosis; 4) self-hypnosis is as effective as hetero-hypnosis. We also argue that highlighting the role of the self in hypnotherapy and hypnosis could increase feelings of self-efficacy, especially given that it can be considered a skill that can be advanced and implies self-control and not “mind-control”. Highlighting the role of phenomenological control by the patient could also increase the uptake of hypnotherapy as treatment for various disorders.

Background

Lack of exercise may reduce the quality of life, physical capability, and functional capability of dialysis patients. Home-based exercise seems to be a desirable form of low-cost intervention. But the effectiveness of this intervention in the dialysis population is still unclear. The purpose of this meta-analysis is to provide effective evidence to determine the impact of home-based exercise on functional capacity, physical capacity, muscular strength, biochemical parameters, and health-related quality of life among dialysis patients with end-stage renal disease (ESRD).

Methods

PubMed, Embase, Cochrane Library, and Web of Science were searched from inception to May 2023, to identify potential randomized controlled trials (RCTs) assessing the effectiveness of home-based exercise in dialysis patients with ESRD. Two independent reviewers selected studies, extracted data, and assessed the risk of bias using the Cochrane tool. Evidence summary using fixed or random effects for meta-analysis.

Results

Twelve RCTs including 1008 dialysis patients met the inclusion criteria. The meta-analysis showed significant effects of home-based exercise on physical capacity. Seven studies reported the results of the 6-min walking test, compared with short-term (0–3 months) home-based exercise (P = 0.76), long-term (3–6 months) interventions (P < 0.001) can significantly improve the results of the 6-min walking test. The results showed that home-based exercise did significantly improve patients' VO₂ peak (P = 0.007). Compared with center-based exercise or usual care, home exercise did not significantly improve handgrip strength, quality of life or CRP and other biochemical parameters (P > 0.05).

Conclusion

The results showed that long-term home-based exercise can improve walking ability. In addition, home-based exercise had the benefit on the VO₂ peak of ESRD patients receiving dialysis patients. However, there was no statistically significant difference in handgrip strength, health-related quality of life, CRP, and other biochemical parameters.

Background

Breast, lung and colorectal cancers are 3 of the top 4 most common cancers worldwide. Their treatment with chemotherapy often results in adverse effects on quality of life, fatigue and functional exercise capacity amongst patients. Mind-body therapies, including yoga, Tai chi and Qigong, are commonly used as complementary and alternative therapies in cancer. This meta-analysis evaluates the effects of yoga, Tai chi and Qigong in alleviating the adverse effects of chemotherapy.

Methods

Various databases were systematically interrogated using specific search terms, returning 1901 manuscripts. Removal of duplicates, irrelevant studies, those lacking available data and applying inclusion/exclusion criteria reduced this number to 9 manuscripts for inclusion in the final meta-analyses. Mean differences were calculated to determine pooled effect sizes using RStudio.

Results

This is the first systematic review and meta-analysis to demonstrate significant improvements in fatigue for colorectal cancer patients undergoing chemotherapy with a reduction of −1.40 (95 % CI: −2.24 to −0.56; p = 0.001) observed in mind-body therapy intervention groups.

Conclusion

Yoga, Tai chi and Qigong could all be implemented alongside adjuvant therapies to alleviate the adverse effects on colorectal cancer patient fatigue during chemotherapy treatment.

Review registration

This systematic review and meta-analysis is registered on InPlasy: registration number INPLASY202390035; doi: https://doi.org/10.37766/inplasy2023.9.0035.

Background

Many people with Type 2 Diabetes Mellitus (T2DM) use herbal medicines, some of which can improve glycaemic control. Providing evidence-based advice on herbal medicines could be an effective intervention to improve control of diabetes, if it is designed to address key needs and concerns of T2DM patients.

Aim

To understand the views and experiences of patients and health professionals on herbal treatments for self-management of T2DM.

Method

MEDLINE, EMBASE, CINAHL, SOCIOFILE and Google Scholar were searched for qualitative studies in T2DM patients about their views on herbal medicines. Included papers were analysed using thematic synthesis.

Results

Thirty-one papers (about 30 studies) were included: 20 from low-and-middle income countries, 10 from high income countries, and 1 internet-based study. Almost all studies from high income countries focussed on ethnic minorities. Many people with T2DM wanted a “cure”, and often took advice from friends and family, but also traditional healers and mass media. However, they were reluctant to discuss herbal medicines with health professionals, whom they perceived as “closed-minded”. They based their treatment decisions on personal experience (from “trial-and-error”), availability, cost and convenience of both herbal and conventional medicines. Most health professionals were reluctant to discuss herbal medicines, or recommended against their use, because of lack of knowledge and concerns about their quality, efficacy and potential interactions.

Conclusion

Evidence-based information could help to overcome the current lack of communication about herbal medicines between people with T2DM and health professionals.

Objective

This cross-sectional study examined the relationships between adherence to 24-HMB guidelines (including physical activity [PA], screen time [ST], and sleep) with academic performance and psychological functioning among children and adolescents with depression.

Methods

This study consists of 2165 participants aged 6–17 years with depression. Independent variables were components of 24-HMB guideline adherence, while outcomes of interest were academic performance (i.e., caring about school performance and completion of required homework) and psychological functioning (i.e., resilience and self-regulation). Logistic regression analysis was conducted while adjusting for confounding variables.

Results

Only 1.03 % of the participants adhered to PA + ST + Sleep guidelines. Compared to non-adherence, adherence to PA + ST guidelines was significantly linked to a greater likelihood of caring about school performance (OR = 2.17), while ST + Sleep guidelines adherence was significantly linked to a greater likelihood of caring about school performance (OR = 2.02), completing homework (OR = 2.91), resilience (OR = 2.51), and self-regulation (OR = 2.51). Furthermore, adherence to PA + ST + Sleep guidelines was significantly linked to a higher likelihood of caring about school performance (OR = 5.01), resilience (OR = 2.49), and self-regulation (OR = 2.88) among these participants with depression.

Conclusion

Adhering to 24-HMB guidelines is positively linked to academic performance and psychological functioning among children and adolescents with depression. Thus, establishing healthy lifestyle behaviors should be promoted in school settings.