Complementary Therapies in Clinical Practice最新文献

Background and Purpose

It was aimed to investigate the effects of massage with or without aromatherapy given to patients after colorectal cancer surgery on symptom management in the first three postoperative days.

Materials and methods

This study was carried out with a pretest-posttest randomized controlled design. The study included the aromatherapy massage group (AG; n = 30), the classical massage group (MG; n = 30), and one control group (CG; n = 30). A blend of sweet almond oil, lavender, chamomile, and ginger oil was used in AG. Massage was applied to the foot area, and 20 min of classical massage was performed. Before the pretest, the participants were blinded by not informing them about their group allocations. The analyses were carried out using parametric methods.

Results

Postoperative pain varied significantly over time in all three groups (AG: p = 0.007; η² = 0.150/MG: p = 0.008; η² = 0.559/CG: p = 0.017; η² = 0.132). Anxiety was found to differ between CG and AG and between CG and MG (p < 0.05). In all three groups, nausea-vomiting scores significantly decreased over time (AG: p = 0.002; η² = 0.211/MG: p = 0.004; η² = 0.164/CG: p = 0.021; η² = 0.125). Sleep quality was significantly higher in the massage groups than in the control group only on the second postoperative day (p = 0.011).

Conclusion

Aromatherapy massage had no significant effect on pain, fatigue, nausea, or vomiting compared to MG and CG, and sleep quality was higher in the massage groups compared to CG only on the second postoperative day. On the first three postoperative days, the post-intervention anxiety levels of AG and MG were lower than those of CG.

Clinicaltrials.gov.id

NCT04810299.

Background and purpose

Physical exercise improves physical and psychological health. However, information on the quantitative impact of Traditional Chinese Exercise (TCE) on physical and psychological health remains limited. Therefore, this systematic review and meta-analysis aimed to quantitatively explore the effects of TCE on the physical and psychological health of patients with multiple sclerosis (MS).

Methods

A comprehensive search was conducted across seven electronic databases (PubMed, SCOPUS, CINAHL, Web of Science, Cochrane Library, China National Knowledge Infrastructure, and Wanfang) from their inception to March 7, 2024 using the terms, Taiji, Tai Chi, Tai Chi Chuan, Qigong, Baduanjin, Wuqinxi, Yijinjing, multiple sclerosis, and disseminated sclerosis. Randomized controlled trials (RCTs) and non-RCTs reporting the effects of TCE on physical function or psychological health outcomes in MS patients were included. A random-effects model and 95 % confidence intervals (95 % CI) were used to compute the effect sizes.

Results

Eleven studies, including 461 subjects with MS, were included in this meta-analysis. TCE significantly increased balance (d = 0.88, 95 % CI [0.45, 1.31], p < 0.001, I² = 39.26 %), activities of daily living (d = 1.17, 95 % CI [0.30, 2.04], p < 0.001, I² = 89.15 %), Multiple Sclerosis Impact Scale (MSIS) scores (d = 0.53, 95 % CI [0.12, 0.93], p = 0.01, I² = 0 %), depression (d = 0.66, 95 % CI [0.003, 1.32], p = 0.049, I² = 62.97 %), and Activities-Specific Balance Confidence (ABC) scores (d = 1.30, 95 % CI [0.41, 2.18], p < 0.001, I² = 0 %) compared with control conditions.

Conclusions

This meta-analysis suggests the efficacy of TCE in improving balance, activities of daily living, MSIS scores, depression, and ABC scores in MS patients. However, further high-quality research is warranted to investigate these findings.

Previous studies of human-dog interventions vary in terms of type of interaction, which is rarely quantified, leading to contradictory findings and limited comparability. To uncover the influence of different types of interactions, the present study investigated if it was possible to detect differences in immediate physiological measurements of healthy humans during different standardised types of interaction with a dog. Thirty-three healthy participants (women = 25, men = 8, >18 years) were exposed to four different test situations with standardised types of interaction intensity with a dog in random order: no dog present (CONTROL), looking at a dog (VISUAL), petting a dog (TACTILE) or performing tricks with a dog (ACTIVE). Each test situation lasted 10 min with a 30-min break between each. Heart rate (HR), heart rate variability (HRV) and skin conductance (tonic level (SCL) and peak counts (SCR)) were continuously recorded. Blood pressure (BP) and salivary cortisol (s-cortisol) were measured before and after each test situation. Linear Mixed Models were applied. HR, HRV, BP, SCL and SCR increased with increased interaction with the dog (for all: p < 0.001). HRV increased with decreased HR (p = 0.002), increased SCL (p = 0.027), and SCR (p < 0.001) depending on the type of interaction. Generally, s-cortisol increased with increased HR (p = 0.042), SCL increased with increased SCR (p < 0.001), and SCR increased with increased HRV (p = 0.013), depending on type of interaction. The physiological measurements HR, HRV, BP, SCL and SCR are influenced by different types of dog interaction, and thus it is important to quantify and report the type of interaction in human-dog interaction studies. (ClinicalTrials.gov ID:NCT04696419).

Objective

Stroke is a major public health threat, and both physical activity (PA) and diet are modifiable risk factors for stroke. This study assessed the interaction and joint effects of PA and the dietary inflammatory index (DII) on stroke.

Methods

We included 18,676 participants from the 2007–2020 National Health and Nutrition Examination Survey. The independent associations, interactions, and joint effects of PA and the DII on stroke were assessed by weighted multivariable logistic regression.

Results

The weighted mean age of the participants was 48.24 years, and comprised 703 individuals who had experienced a stroke. After adjusting for confounders, increased stroke risk was independently associated with a higher DII (Q4, odds ratio [OR]: 1.72, 95 % confidence interval [CI]: 1.27–2.34) and insufficient PA (inactive, OR: 1.37, 95 % CI: 1.05–1.78). No significant multiplicative (OR: 1.11, 95 % CI: 0.34–1.93) or additive (relative excess risk due to interaction: 0.45, 95 % CI: 0.35–1.25) interactions were found between DII and PA. The results of joint associations indicated that individuals who consumed the most pro-inflammatory diet (DII, Q4) and were physically inactive (OR: 2.39, 95 % CI: 1.61–3.56) had the highest stroke risk than those who consumed the most anti-inflammatory diet (DII, Q1) and were physically active.

Conclusion

Active PA and low DII scores are independent protective factors against stroke. Although the multiplicative and additive effects of the DII and PA on stroke risk are not statistically significant, the analysis of their joint effects suggest that individuals who consume anti-inflammatory diets and exhibit active PA consistently have the lowest risk of stroke.

The therapeutic alliance is a principal element that allows the dynamics and effects of psychotherapy to be analyzed. In the past half-century, many studies have explored various psychotherapeutic approaches, including psychoanalytic, cognitive-behavioral and systemic psychotherapy, but hypnotherapy has not been addressed. This article presents the first analysis using current methods of verifying and understanding the dynamics of change in hypnotherapy, regarding to the therapeutic alliance. Luborsky et al.‘s (1996) revised Helping Alliance Questionnaire (HAq-II) was administered to 59 patients in treatment with psychologists and psychiatrists using Ericksonian hypnosis. Our results suggest that the dynamics of the alliance in the first sessions of hypnotherapy involve factors related more to the therapist's adjustment to the patient than to the progress the patient makes in these initial sessions.

Background

and purpose: Little is known about the training and experience of osteopaths who treat paediatric patients, and graduates report feeling unprepared for this aspect of practice. The purpose of this study was to investigate the lived experience of Australian osteopaths who regularly treat these patients, in order to better understand their individual educational pathways and their management of this population.

Materials and methods

Osteopaths who reported regularly treating paediatric patients were recruited through the Osteopathy Research and Innovation Network (ORION) national practice-based network. Semi-structured interviews were completed, transcribed and thematically analysed using the principles of Descriptive Phenomenology to compile qualitative data.

Results

Ten osteopaths were interviewed, whose age ranged from 33 to 71 years and with 15–46 years of clinical experience. Proportion of paediatric patients ranged from 20 to 90 % of participants’ caseload according to self-report. Seven themes were identified that reflected the lived experience of treating paediatric patients: 1) Variable pathways to practice, 2) Challenges and rewards, 3) Scope of practice, 4) Team-based care, 5) Importance of entry-level skills, 6) Family-centred care, and 7) Success.

Conclusion

The study found a diversity of educational pathways, that paediatric practice was highly rewarding, the scope of practice was based on diagnostic skills and experience, the practitioners had extensive team-based professional networks, practice reflected a family-centred care model, and personal measures of success were multifactorial. These results give insight into this area of practice to guide further research.

Background

and Purpose: Outdoor play is widely acknowledged for its benefits to physical health and psychological well-being, yet its relationship with school readiness remains understudied in preschoolers. To address this gap in the literature, this study investigated how outdoor play relates to cognitive and psychosocial development among a nationally representative sample of preschoolers.

Materials and method

Data on the duration of outdoor play (on weekdays and weekends) and specific cognitive and psychosocial outcome variables (i.e., early learning skills, self-regulation, social-emotional development, and flourishing) were collected via questionnaires provided to the caregivers of preschoolers. Logistic regressions were performed to examine the associations between outdoor play with cognitive and psychosocial outcomes while adjusting for covariates and calculate the odds ratio with 95 % confidence intervals (CI).

Results

Among the 10,682 preschoolers (i.e., 3-5y) included in this study (i.e., 5558 boys, Mage = 3.98 ± 0.99 years), there was a lower percentage of preschoolers engaged in outdoor play for over 3 h per day on weekdays (33.39 %) compared to weekends (56.85 %). Outdoor play in preschoolers is positively associated with various domains of school readiness, and engaging in outdoor play for more than 3 h per day is associated with more beneficial outcomes.

Conclusion

The findings of this cross-sectional study suggest that promoting outdoor play among preschoolers can be an effective strategy for enhancing cognitive, social, and emotional development in this age group although further intervention studies are required to buttress this assumption empirically.

Objectives

This study aimed to explore the synergistic impact of online yoga, mindfulness practices, and probiotics on irritable bowel syndrome (IBS) by evaluating changes in physical fitness, mental health, and gut microbiota composition.

Design, setting and interventions

The six-week randomized, double-blinded, placebo-controlled trial included 31 IBS patients categorized into three groups: online yoga with probiotics (EP), online yoga with a placebo (EC), and probiotics only (P). Assessments involved physical fitness tests, subjective questionnaires (IBS-QOL, BSRS-5), and gut microbiome analysis.

Main outcome measures

Participants self-collected stool samples and were given a set of questionnaires at baseline and after six weeks of intervention. Their symptoms were measured by changes in the gut microbiota, physical fitness and quality of life, and psychological well-being.

Results

The EP group demonstrated improved cardiovascular endurance (P < 0.001) and a significant reduction in Klebsiella bacterial strains (P < 0.05). Both the EP and EC groups exhibited significantly decreased IBS-QOL scores (P < 0.001 and P < 0.05, respectively), indicating enhanced quality of life. While BSRS-5 scores decreased in both groups, the reduction was statistically insignificant.

Conclusion

Integrating online yoga, mindfulness practices, and probiotics demonstrated comprehensive benefits for IBS patients. This intervention improved physical fitness and mental well-being and positively influenced gut microbiota composition. The study highlights the potential of this multifaceted approach in managing IBS symptoms and enhancing overall health, emphasizing the relevance of the gut-muscle-brain axis in understanding and addressing IBS complexities.

Trial registration

Taiwanese Registry of Institutional Review Board IRBHP210009/CH11000259.

Background

and Purpose: With mindfulness being increasingly recognized for its potential to address psychological challenges related to advanced or terminal illnesses, palliative care professionals are incorporating mindfulness-based interventions into their practice. However, there is limited understanding of the practical applications of mindfulness in clinical settings, particularly for end-of-life patients. This study explored palliative care professionals’ experiences in delivering mindfulness-based therapy to end-of-life patients, thereby aiming to inform the development of effective interventions.

Materials and methods

Semi-structured interviews were conducted with 15 palliative care professionals. Participants were asked to describe their memorable experiences in applying mindfulness in a clinical setting. Data were analyzed following Moustakas's transcendental phenomenology approach.

Results

The interviews produced three themes: clinicians’ mindfulness experiences form the cornerstone of their clinical application of mindfulness; creating an optimal healing environment is essential for mindfulness practice; and patient-centric mindfulness guidance should be implemented.

Conclusion

This study underscores the critical role of mindfulness in end-of-life care, highlighting its integration into daily life by palliative care professionals. By drawing upon their own mindfulness experiences, palliative care professionals facilitated a therapeutic environment tailored to the unique needs of end-of-life patients. This patient-centered approach not only enhanced the quality of care but also fostered a healing connection rooted in compassion and empathy. The findings advocate for further education and development of mindfulness-based interventions, including group therapies, to support the holistic well-being of patients in collectivist cultures. Future research should further explore the practical applications and benefits of mindfulness in end-of-life care settings.

Background

Contemporary 24-h movement behavior (24-HMB) guidelines provide recommendations on time spent on physical activity (PA), screen time (ST), and sleep (SL). There is evidence of physiological and psychological health benefits associated with meeting such guidelines. However, the prevalence of meeting 24-HMB guidelines among youth prescribed eyeglasses/contact lenses is less clear. The primary purpose of this cross-sectional analysis was to examine the prevalence of partially or fully meeting 24-HMB guidelines in U.S. youth prescribed eyeglasses/contact lenses, and variations in meeting the guidelines by demographic, health status, and environmental attributes.

Methods

Data from the 2021 National Survey of Children's Health (NSCH) yielded a target subpopulation of 8523 youth aged 6–17 years (54.22 % girls) prescribed eyeglasses/contact lenses. The representative sample of US children and adolescents was used to estimate the prevalence of meeting 24-HMB guidelines, and a multinomial logistic regression analysis was conducted to examine the odds of meeting 24-HMB guidelines by demographic, health status, and environmental variables.

Results

Overall, only 6.57 % met all three 24-HMB guidelines, 23.74 % did not meet any of the three 24-HMB guidelines, and 3.57 %, 10.88 %, and 29.98 % met single guidelines for physical activity, screen time, or sleep duration, respectively, while 25.27 % met any of two 24-HMB guidelines. Female participants were less likely to meet PA + SL guidelines (OR = 0.57, 95 % CI [0.38, 0.56]) but more likely to meet ST + SL guidelines (OR = 1.52, 95 % CI [1.20, 1.91]). Hispanic participants were less likely to meet PA + ST (OR = 0.28, 95 % CI [0.14, 0.52]) guidelines and all three guidelines (OR = 0.41, 95 % CI [0.23, 0.71]) while participants identified as black (OR = 0.33, 95 % CI [0.21, 0.51]) were significantly less likely to meet ST + SL guidelines. With respect to health status, overweight status, repeated/chronic physical pain, and born premature, were detrimentally associated with meeting two or more 24-HMB guidelines. Living in neighborhoods with parks or playgrounds and neighborhood safety were positively linked to meeting the guidelines while living in neighborhoods with sidewalks or walking paths was negatively linked to meeting PA + ST guidelines.

Conclusion

In U.S. youth prescribed eyeglasses/contact lenses the prevalence of meeting all three 24-HMB guidelines was low, especially the low prevalence observed in female participants, Hispanic and black participants, participants with overweight status, repeated/chronic pain, born premature, living in neighborhoods with sidewalks. Policy makers should take initiative to promote integrated guidelines among this special age group for health benefits.