Advances in integrative medicine最新文献

Background

Changes in routine due to the pandemic have increased nursing students' anxiety about clinical learning. The inadequacy experienced before graduation caused them to experience high levels of anxiety characterized by feelings of insecurity and unhappiness and negatively affected their life satisfaction. Methodological studies are needed to confirm the efficacy of laughter therapy, which is effective in reducing anxiety and stress, on the online platform. The current study protocol was designed to evaluate the effect of online laughter therapy on anxiety, life satisfaction, and psychological well-being.

Methods

Forty students were selected for the intervention group and forty students for the control group by assigning 1:1 with a real random number selector among 140 senior nursing students who made up the universe. The intervention group received ten sessions of online laughter therapy two days a week for five weeks. Participants in the control group did not receive any intervention during the study. Data were obtained at the beginning of the study and after five weeks with the 'State-Trait Anxiety Inventory', 'Satisfaction with Life Scale' and 'Psychological Well-Being Scale'.

Results

After laughter therapy, the intervention result showed a significant increase in life satisfaction and psychological well-being scores (p < 0.001) and a significant decrease in anxiety scores (p < 0.001) in the intervention group compared to the control group.

Conclusion

The study reveals that online laughter therapy significantly positively affects nursing students' anxiety, life satisfaction, and psychological well-being.

Objective

To examine the effects of massage on childbirth satisfaction in women with a healthy single fetus.

Methods

In this systematic review and meta-analysis, databases in English and Persian (PubMed, Cochrane Library, Embase, Google Scholar, Scopus, Web of science, SID, Magiran) were systematically searched until April 28, 2022. The risk of bias for each study was assessed using Cochran's handbook and meta-analysis was performed using RevMan 5.3 software and the quality of evidence was assessed using the GRADE approach.

Results

A total of 2286 articles were found after searching the relevant databases; among them 1319, 931, and 36 articles were screened by reviewing their titles, abstracts, and full texts, respectively. Finally, 6 articles with a sample size of 615 participants were included in this systematic review. The results of a meta-analysis on dichotomous data (OR: 4.95, 95% CI: 1.86–13.17, two trials, 110 women) and another meta-analysis on continuous data (SMD: 0.92; 95% CI: 0.20–1.65, three trials, 260 women) showed that massage had a statistically significant effect on improving childbirth satisfaction.

Conclusion

The results of this meta-analysis indicated that massage significantly improved labor satisfaction in the intervention group compared to the control group. Researchers are suggested to carry out well-designed clinical trials, use reliable tools such as the Labor Agentry Scale and Mackey Childbirth Satisfaction Rating Scale (MCSRS) to assess the effect of massage on childbirth satisfaction, and report side effects of massage in the participants as a separate outcome in future studies.

Background

The management of diabetes involves the use of pharmacological agents and non-pharmacological interventions with diet adjustment and active exercise at the core of non-pharmacological treatment. Passive exercise in the form of electrical muscle stimulation may also be of therapeutic value in modulating blood glucose via muscle strengthening and fat reduction. The objective of this research is to investigate the impact of treadmill running and burst-modulated biphasic pulsed current individually and in combination on glycaemic control, central obesity and body image in individuals with Type 2 Diabetes (T2D).

Methods

One hundred and sixty four individuals with T2D will be randomized into one of four groups: three intervention groups (treadmill running, burst-modulated biphasic pulsed current [BMBPC] stimulation, and combined treadmill running with BMBPC stimulation) as well as a control (non-exercise) group. Outcomes including glycaemic control, central obesity, and body image will be assessed at baseline as well as 6th and 12th week of intervention with a follow-up assessment three months after intervention. Data will be analyzed using descriptive and inferential statistics after normality tests have been carried out. Alpha probability level will be significance at 0.05.

Discussions

The study outcome will determine the individual and combined effect of BMBPC and treadmill running on glycaemic control, central obesity, and body image in persons with T2D.

Trial Registration

The registration number for the trial is PACTR202101600277020.

Rheumatoid arthritis (RA) is a chronic debilitating disease most commonly seen in middle-aged women and that has unique challenge in its management. A 30 year old woman diagnosed with RA for 4 years presented with severe morning stiffness, pain, occasional numbness and tingling in her hands, wrists, as well as elbows with gait aberration. She also presented with ulnar deviation and swan neck deformity and reported an inability to perform her daily chores. She was not on any medication when she was admitted in an alternative health care setting where she was intervened with a specified protocol of yoga & naturopathy based lifestyle intervention (YNBL) which included yoga therapy, hydrotherapy, manipulative therapies, physiotherapy, western acupuncture, therapeutic fasting and dietary modifications for 3 months. The patient was followed-up for a period of 3 months from discharge. The data reveals significant improvement in the RA related Quality of Life scores (28−4), Visual analog score for pain (8−2), weight (30–35 kg), hemoglobin (9–9.8 gm/dl), erythrocyte sedimentation rate (80–28 mm/hr), RA factor (81.5–65 IU/mL), Anti- Citrullinated Protein Antibody (410–198 EU/mL). YNBL protocol was well tolerated by the patient and has shown significant reduction in inflammation, improvement in quality of life as well reversal of structural deformity. The results are encouraging to conduct large scale randomized control trials to explore the possibility of utilizing YNBL in the management of RA.

Background and purpose

Gastroesophageal reflux disease (GERD) has an adverse impact on the quality of life of affected individuals. Diaphragmatic breathing training (DBT) my be effective in GERD, but research on the benefits of this complementary therapy for affected patients is scarce. This study was therefore intended to examine the effects of DBT on the quality of life and clinical symptoms of patients with GERD.

Materials and methods

This is a randomized controlled trial with two-parallel groups. The experimental group (n = 47) received four weeks of DBT sessions plus treatment-as-usual, while the control group (n = 49) maintained treatment-as-usual only. The outcome variables were measured using the Reflux Disease Questionnaire and GERD-Quality of Life questionnaire. The questionnaires were completed before and after the intervention.

Results

The mean scores of symptom frequency (p < 0.001), symptom severity (p < 0.001) and quality of life (p = 0.001) decreased significantly after the intervention in the two groups. The results also showed that the difference between before and after intervention for mean scores of symptom frequency (p = 0.006), symptom severity (p = 0.001) and quality of life (p = 0.004) was significant in the experimental group compared to the control group. Furthermore, no statistically significant difference in patients' satisfaction with their condition was found between the two groups before (p = 0.698) and after (p = 0.124) the intervention.

Conclusion

Diaphragmatic breathing training can alleviate symptoms and improve quality of life in patients with GERD.

Background

The aim was to explore experiences of individuals with the controversial conditions bile acid diarrhoea (BAD) and bile acid malabsorption (BAM). BAD/BAM are poorly understood, misdiagnosis is common and there is evidence that around a third of patients with Irritable Bowel Syndrome (diarrhoea) (IBS-D) may have BAD/BAM.

Methods

In depth, semi-structured interviews were undertaken with six participants, all female, 18 + years old and living in the UK. All had been diagnosed with BAD/BAM for at least one year. Interviews were recorded and transcribed verbatim. Data was coded and thematic analysis was undertaken using grounded theory.

Results

Six main themes emerged including 1. triggers, and how to control symptoms; 2. experience of diagnosis/care and associated delays; 3. psychosocial impact of the condition, this specifically identified impacts on mental health; 4. the signs and symptoms; 5. comorbidities and other health problems and finally 6. self-education/learning for management of BAD/BAM. Findings indicate that BAD and BAM are often poorly understood; and patients experience delays with diagnosis and moreover that the condition has profound effects on the lives of patients including impacting on mental health. A low-fat diet was identified as useful in managing symptoms, however participants had concerns over absorption of fat-soluble vitamins such as vitamin D and often experienced fatigue.

Conclusion

Further research is recommended to understand both the psychosocial and nutritional impacts of BAD/BAM and to understand the management strategies of patients and the potential role of integrative medicine in caring for this group.

Objectives

New Zealand has experienced an increase in the use of traditional and complementary medicine treatment modalities, such as that of naturopathy. Limited research exists that has examined older aged New Zealanders utilisation of naturopathic treatment modalities. Therefore, the primary aim of this study was to provide a demographic profile of older adults who attended a student naturopathic clinic over a 2-year period. A secondary aim was to identity the symptoms or conditions for which treatment was sought.

Methods

De-identified data were collected for 76 older-aged (>65 years) clients, 28 male and 48 female clients aged between 65 and 88 years of age (71 ± 5.8).

Results

The majority of older aged clients who attended the clinic, were female, in the young-old age group (65–74 years of age) and identified as being New Zealand European. Treatment was predominately sought for chronic health conditions, such as constipation, chronic pain, and arthritis.

Conclusions

The older aged clients in our study were predominately seeking naturopathic treatment for the management of their chronic health conditions.

Background

Quality of sleep is usually compromised in the geriatric population resulting in excessive daytime sleepiness, difficulty sustaining attention, slowed response time, difficulty with memory, and decreased performance. Acupuncture has been established as an alternative therapy, but methodological research still needs to verify its efficacy in sleep disturbances. Hence, a pilot placebo-controlled trial was designed to assess 3 acupuncture point's effect on sleep quality in the geriatric population staying in a nursing home.

Methods

A total of 40 elderly subjects with self-reported sleep disturbance (age with mean± SD = 69.55 ± 7.80) were recruited and allocated to two groups comprising an experimental (n = 20) and a control group (n = 20). Participants were randomly allocated with an allocation ratio of 1:1. Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) scores were obtained at baseline and following two weeks. Subjects in the experimental group received needling of Shenmen (HT-7), Baihui (GV-20) and Yintang (EX-HN-3) acupoints for 30 min per day for two weeks, and the control group received placebo points during the respective interventions.

Results

After two weeks of acupuncture, the intervention result showed a significant reduction in all components of PSQI and global PSQI scores (p < 0.001) and a significant increase in ESS score (p < 0.001) in the experimental group compared to the control group.

Conclusion

The study reveals that two weeks of acupuncture intervention significantly positively affect sleep quality in older adults.

Autoimmune hepatitis (AIH) is a chronic and progressive inflammatory process of the liver, with standard treatments including prednisone, azathioprine, and ultimately liver transplant. While there are many integrative and Ayurvedic treatment options that have been shown to be helpful for other liver diseases, there are no studies that have been performed to evaluate these therapies particularly in AIH with cirrhosis. We detail the case of a 55-year-old female with cirrhosis in the setting of AIH placed on a liver transplant list after being treated with conventional therapies. She was started on various nutritional supplements and Ayurvedic treatments which resulted in a significant decrease in her Model for End-Stage Liver Disease score, which was sustained at 7 months. This is the first case report to our knowledge detailing an integrative approach to cirrhosis in the setting of AIH showing such an improvement in liver function. This paper outlines a novel approach to Autoimmune hepatitis with cirrhosis that utilizes a collaboration between Conventional, Integrative and Ayurvedic practitioners. While the basic science supports the efficacy of the individual treatments utilized in this case, there have been no published case reports outlining the safety and efficacy of these treatments when combined in a clinical setting of cirrhosis due to Autoimmune hepatitis. Thus, we set out to detail the first such case report to our knowledge of an integrative approach to cirrhosis in the setting of AIH showing such an improvement in liver function.