Feasibility study protocol to examine the role of mantra meditation at reducing psychological distress in emergency department staff

Background: Work in a healthcare setting can affect the psychological wellbeing of healthcare professionals (HCPs). Emotional exhaustion among HCPs can have a significant negative impact on the quality of healthcare provided to patients in terms of increased medical errors and decreased patient satisfaction. There is a need for an effective stress-reducing intervention, such as mantra meditation. This feasibility study will examine the suitability of random controlled trial (RCT) methodology to assess the efficacy of mantra meditation at reducing emotional exhaustion among emergency department (ED) staff. Methods: This is a mixed methods, stratified feasibility study with intent-to-treat protocol, using two study arms (passive control and intervention), the purpose of which is to examine (1) recruitment, retention, and adherence; (2) outcome measures (psychological wellbeing and stress-related biological parameters such as blood pressure, heart rate variability and salivary cortisol); and (3) data management, control, and dissemination prior to conducting a full RCT.Results Eligible ED staff allocated to the intervention group (n = 30) will be taught mantra meditation and discuss prescribed texts (4 x 4 hour session over 6 weeks), as well as engage in 20 minutes of twice-daily mantra meditation practice. Participants in the passive control group (n = 30) will work as usual. Data will be collected pre (T1), post (week 11; T2) and at follow-up (week 19; T3). Conclusions: This study will pave the way for a larger RCT that will investigate mantra meditation as a definitive intervention to reduce emotional exhaustion among ED staff.

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The Effect of Inquiry-Based Stress Reduction on Teacher Burnout: A Controlled Trial

Brain Sciences ◽

10.3390/brainsci10070468 ◽

2020 ◽

Vol 10 (7) ◽

pp. 468 ◽

Cited By ~ 1

Author(s):

Lia Schnaider-Levi ◽

Ariel B. Ganz ◽

Keren Zafrani ◽

Zehavit Goldman ◽

Inbal Mitnik ◽

...

Keyword(s):

Emotional Exhaustion ◽

Stress Reduction ◽

Passive Control ◽

Teacher Burnout ◽

High Stress ◽

Intervention Group ◽

Well Being ◽

Personal Accomplishment ◽

Control Group ◽

Economic Costs

Burnout is a well-known phenomenon with significant social, biological and economic costs. In particular, teacher burnout is associated with unfavorable mental health outcomes and economic costs due to reduced hours and teacher turnover. This study investigated the effect of an Inquiry-Based Stress Reduction (IBSR) cognitive-reframing program on teacher burnout using a quasi-experimental design. Fifty-three teachers participated in a prospective intervention with a passive control group. The intervention group completed a 12-week IBSR program with 4.5 h of weekly engagement. Relative to control, teachers in the intervention group showed greater improvements in emotional exhaustion (18.8 ± 5.2 to 15.9 ± 5.7 vs. 16.0 ± 4.8 to 17.4 ± 4.8; p = 0.01) and personal accomplishment (21.8 ± 5.0 to 24.6 ± 4.3 vs. 21.9 ± 4.5 to 22.8 ± 4.3; p = 0.04). Significant correlations were found between change in emotional exhaustion and negative affect (positive correlation; r = 0.32; p = 0.034) and between personal accomplishment and perceived stress (negative correlation; r = −0.451; p = 0.002). This study demonstrates the potential of IBSR to improve teacher well-being. Future randomized studies are needed to evaluate the causality of IBSR in reducing burnout among teachers and other high-stress workplaces.

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Effects of a diuretic adjustment algorithm protocol on heart failure admissions: A randomized clinical trial

Journal of Telemedicine and Telecare ◽

10.1177/1357633x211009640 ◽

2021 ◽

pp. 1357633X2110096

Author(s):

Maria KEF Feijó ◽

Karen Brasil Ruschel ◽

Daniela Bernardes ◽

Eduarda B Ferro ◽

Luis E Rohde ◽

...

Keyword(s):

Clinical Trial ◽

Emergency Department ◽

Randomized Clinical Trial ◽

Intervention Group ◽

Heart Association ◽

Functional Class ◽

Emergency Department Visits ◽

Control Group ◽

Point Change ◽

Clinical Instability

Introduction The aim of this study was to evaluate the effectiveness of a diuretic adjustment algorithm (DAA) in maintaining clinical stability and reducing HF readmissions using telemonitoring Technologies. Methods Randomized clinical trial of patients with an indication for furosemide dose adjustment during routine outpatient visits. In the intervention group (IG), the diuretic dose was adjusted according to the DAA and the patients received telephone calls for 30 days. In the control group (CG), the diuretic dose was adjusted by a physician at baseline only. Co-primary outcomes were hospital readmission and/or emergency department visits due to decompensated HF within 90 days, and a 2-point change in the Clinical Congestion Score and/or a deterioration in New York Heart Association functional class within 30 days. Results A total of 206 patients were included. Most patients were male ( n=119; 58%), with a mean age of 62 (SD 13) years. Four patients (2%) in the IG and 14 (7%) in the CG were hospitalized for HF (odds ratio (OR) 0.31 (0.10–0.91); p=0.04). Multivariate analysis showed a reduction of 67% in readmissions and/or emergency department visits due to decompensated HF in the IG compared with the CG (95% CI 0.13–0.88; p=0.027). Regarding the combined outcome of HF readmission and/or emergency department visits or clinical instability, the IG had 20% fewer events than the CG within 30 days (IG: n=48 (23%), CG: n=70 (34%); OR 0.80 (0.63–0.93); p=0.03). Discussion Using DAA improved the combined outcome in these outpatients, with favorable and significant results that included a reduction in HF admissions and in clinical instability. (NCT02068937)

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Asthma in Adolescents: A Randomized, Controlled Trial of an Asthma Program for Adolescents and Young Adults with Severe Asthma

Canadian Respiratory Journal ◽

10.1155/2002/106262 ◽

2002 ◽

Vol 9 (4) ◽

pp. 253-259 ◽

Cited By ~ 21

Author(s):

Robert L Cowie ◽

Margot F Underwood ◽

Cinde B Little ◽

Ian Mitchell ◽

Sheldon Spier ◽

...

Keyword(s):

Quality Of Life ◽

Emergency Department ◽

Randomized Controlled Trial ◽

Asthma Control ◽

Controlled Trial ◽

Intervention Group ◽

Control Group ◽

Randomized Controlled ◽

Disease Specific

BACKGROUND: Asthma is common and is often poorly controlled in adolescent subjects.OBJECTIVE: To determine the impact of an age-specific asthma program on asthma control, particularly on exacerbations of asthma requiring emergency department treatment, and on the quality of life of adolescents with asthma.METHODS: The present randomized, controlled trial included patients who were 15 to 20 years of age and had visited emergency departments for management of their asthma. The interventional group attended an age-specific asthma program that included assessment, education and management by a team of asthma educators, respiratory therapists and respiratory physicians. In the control group, spirometry was performed, and the patients continued to receive usual care from their regular physicians. The outcomes were assessed by a questionnaire six months after entry into the study.RESULTS: Ninety-three subjects entered the study and were randomly assigned to the intervention or control group. Of these, only 62 patients were available for review after six months. Subjects in both the control and the intervention groups showed a marked improvement in their level of asthma control, reflected primarily by a 73% reduction in the rate of emergency department attendance for asthma. Other indexes of disease control, including disease-specific quality of life, as assessed by questionnaires, were improved. There was, however, no discernible difference between the subjects in the two groups, with the exception of an improvement in favour of the intervention group in the symptom (actual difference 0.7, P=0.048) and emotional (actual difference 0.8, P=0.028) domains of the asthma quality of life questionnaire. The overall quality of life score favoured the intervention group by a clinically relevant difference of 0.6, but this difference did not reach statistical significance (P=0.06).CONCLUSIONS: Although all subjects demonstrated a significant improvement in asthma control and quality of life, the improvement attributable to this intervention was limited to two domains in disease-specific quality of life.

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Feasibility study of peer-led and school-based social network Intervention (STASH) to promote adolescent sexual health

Pilot and Feasibility Studies ◽

10.1186/s40814-021-00835-x ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Kirstin R. Mitchell ◽

Carrie Purcell ◽

Sharon A. Simpson ◽

Chiara Broccatelli ◽

Julia V. Bailey ◽

...

Keyword(s):

Sexual Health ◽

Sex Education ◽

Feasibility Study ◽

Intervention Group ◽

Weight Of Evidence ◽

Control Group ◽

Programme Theory ◽

Scale Evaluation ◽

Social Network Intervention

Abstract Background Effective sex education is the key to good sexual health. Peer-led approaches can augment teacher-delivered sex education, but many fail to capitalise on mechanisms of social influence. We assessed the feasibility of a novel intervention (STASH) in which students (aged 14–16) nominated as influential by their peers were recruited and trained as Peer Supporters (PS). Over a 5–10-week period, they spread positive sexual health messages to friends in their year group, both in-person and via social media, and were supported to do so via weekly trainer-facilitated meetings. The aims of the study were to assess the feasibility of STASH (acceptability, fidelity and reach), to test and refine the programme theory and to establish whether the study met pre-set progression criteria for continuation to larger-scale evaluation. Methods The overall design was a non-randomised feasibility study of the STASH intervention in 6 schools in Scotland. Baseline (n=680) and follow-up questionnaires (approx. 6 months later; n=603) were administered to the intervention year group. The control group (students in year above) completed the follow-up questionnaire only (n=696), 1 year before the intervention group. The PS (n=88) completed a brief web survey about their experience of the role; researchers interviewed participants in key roles (PS (n=20); PS friends (n=22); teachers (n=8); trainers (n=3)) and observed 20 intervention activities. Activity evaluation forms and project monitoring data also contributed information. We performed descriptive quantitative analysis and thematic qualitative analysis. Results The PS role was acceptable; on average across schools >50% of students nominated as influential by their friends, signed up and were trained (n=104). This equated to 13% of the year group. Trained PS rarely dropped out (97% completion rate) and 85% said they liked the role. Fidelity was good (all bar one trainer-led activity carried out; PS were active). The intervention had good reach; PS were reasonably well connected and perceived as ‘a good mix’ and 58% of students reported exposure to STASH. Hypothesised pre-conditions, contextual influences and mechanisms of change for the intervention were largely confirmed. All bar one of the progression criteria was met. Conclusion The weight of evidence supports continuation to full-scale evaluation. Trial registration Current controlled trials ISRCTN97369178

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A parental educational intervention to facilitate informed consent for pediatric procedural sedation in the emergency department: a parallel group randomized controlled trial

10.21203/rs.3.rs-27624/v1 ◽

2020 ◽

Author(s):

Yen-Ko Lin ◽

Yung-Sung Yeh ◽

Chao-Wen Chen ◽

Wei-Che Lee ◽

Chia-Ju Lin ◽

...

Keyword(s):

Emergency Department ◽

Informed Consent ◽

Controlled Trial ◽

Intervention Group ◽

Informed Consent Process ◽

Consent Process ◽

Procedural Sedation ◽

Control Group ◽

Randomized Controlled ◽

Video Assisted

Abstract Background Obtaining valid parental informed consent for pediatric procedures in the emergency department (ED) is challenging. This study compared a video-assisted informed consent intervention with conventional consent discussion to inform parents about pediatric procedural sedation in the ED. Methods A video-assisted informed consent intervention was developed to explain the process, benefits, risks, and alternatives of pediatric procedural sedation. A prospective randomized controlled trial was conducted with a convenience sample of parents of children recommended for procedural sedation for facial laceration in the ED. Intervention group participants watched the video. Control group participants received information from physicians during conventional discussion. Participants completed pre- and post-education knowledge tests and rated their satisfaction with the informed consent process. The primary outcome was efficacy of the video intervention compared with conventional discussion. Secondary outcomes were parental satisfaction and consent refusal. A covariate-controlled multivariable regression model was used to analyze between-group differences in knowledge and satisfaction. Results There were 32 participants in the intervention group and 30 in the control group. Mean knowledge scores were higher in the intervention group (91.67 ± [standard deviation] 12.70) than in the control group (73.33 ± 19.86). The intervention group showed significantly greater knowledge score differences (coefficient: 18.931, 95% confidence interval: 11.146–26.716). Intervention group participants showed greater satisfaction than control group participants. Conclusions Video-assisted informed consent was superior to conventional discussion for informing parents during an ED informed consent process. Video-assisted informed consent may improve parents’ understanding of pediatric procedural sedation and satisfaction with the informed consent process in the ED. Institutions should develop structured methods and strategies to better inform parents, facilitate treatment decisions, and improve parent satisfaction in the ED. Trial registration: The ClinicalTrials.gov Identifier is NCT01850329. Registered 9 May, 2013 - Retrospectively registered, https://www.clinicaltrials.gov/ct2/show/study/NCT01850329

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Effect of rehabilitation training on an elderly population with mild to moderate hearing loss: study protocol for a randomised clinical trial

F1000Research ◽

10.12688/f1000research.23332.2 ◽

2020 ◽

Vol 9 ◽

pp. 582

Author(s):

Parisa Rasouli Fard ◽

Farnoush Jarollahi ◽

Seyyed Jalal Sameni ◽

Mohammad Kamali

Keyword(s):

Clinical Trial ◽

Hearing Loss ◽

Negative Impact ◽

Intervention Group ◽

Randomised Clinical Trial ◽

Control Group ◽

Rehabilitation Training ◽

Speech In Noise ◽

Age Related ◽

Moderate Hearing Loss

Background: Age-related hearing loss (presbycusis) is a form of hearing loss in over 60-year-olds and has a negative impact on quality of life. The pathophysiology of presbycusis is multifactorial and is predominately characterised with a loss of speech perception in noise. In the cochlea, auditory filters decompose broadband sound into a series of narrowband output signals, which contains two kinds of temporal information: slow changes in overall amplitude envelope (ENV) and faster variations in temporal fine structure (TFS). TFS is important for recognition of target speech in noise. The main aim of the study is to evaluate the effect of TFS rehabilitation training in participants over the age of 60 years with mild to moderate hearing loss. Methods: A randomised clinical trial conduct on 30 participants with mild (loss of 20-39dB) to moderate (40-69dB) hearing loss, aged between 60 and 75 years old. Participants with conductive hearing loss, abnormal middle ear pathology and central nerve system disease were excluded. Participants were randomly selected to an intervention and control group with a 1:1 ratio. Rehabilitation for the intervention Group are 30-minute sessions three times a week for a total five weeks of vowel consonant vowel words that are used to eliminate ENV and keep only TFS. Word in noise test, binaural TFS test, and Speech, Spatial and Qualities of Hearing Scale scores are performed at the beginning and end of study to evaluate the effect of rehabilitation training. Conclusion: Life expectancy in the elderly has improved, leading to an increased prevalence of age-related diseases including presbycusis. A literature review highlighted that TFS damage is permanent; however, in this study we will attempt to prove that TFS training may lead to speech in noise perception restored. Trial registration: Registry of Clinical Trials, IRCT2019625044006N1 (7th August 2019).

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P092: Combatting sedentary lifestyles; can exercise prescriptions in the emergency department lead to a behavioural change in patients?

CJEM ◽

10.1017/cem.2018.290 ◽

2018 ◽

Vol 20 (S1) ◽

pp. S89-S89

Author(s):

D. Lewis ◽

K. Leech-Porter ◽

F. Milne ◽

J. Fraser ◽

S. Hull ◽

...

Keyword(s):

Emergency Department ◽

Primary Outcome ◽

Exercise Prescription ◽

Behavioural Change ◽

Significant Proportion ◽

Intervention Group ◽

Routine Care ◽

Control Group ◽

Post Hoc

Introduction: Patients with chronic diseases are known to benefit from exercise. Such patients often visit the emergency department (ED). There are few studies examining prescribing exercise in the ED. We wished to study if exercise prescription in the ED is feasible and effective. Methods: In this pilot prospective block randomized trial, patients in the control group received routine care, whereas the intervention group received a combined written and verbal prescription for moderate exercise (150 minutes/week). Both groups were followed up by phone at 2 months. The primary outcome was achieving 150 min of exercise per week. Secondary outcomes included change in exercise, and differences in reported median weekly exercise. Comparisons were made by Mann-Whitney and Fishers tests (GraphPad). Results: Follow-up was completed for 22 patients (11 Control; 11 Intervention). Baseline reported median (with IQR) weekly exercise was similar between groups; Control 0(0-0)min; Intervention 0(0-45)min. There was no difference between groups for the primary outcome of 150 min/week at 2 months (Control 3/11; Intervention 4/11, RR 1.33 (95%CI 0.38-4.6;p=1.0). There was a significant increase in median exercise from baseline in both groups, but no difference between the groups (Control 75(10-225)min; Intervention 120(52.5-150)min;NS). 3 control patients actually received exercise prescription as part of routine care. A post-hoc comparison of patients receiving intervention vs. no intervention, revealed an increase in patients meeting the primary target of 150min/week (No intervention 0/8; Intervention 7/14, RR 2.0 (95%CI 1.2-3.4);p=0.023). Conclusion: Recruitment was feasible, however our study was underpowered to quantify an estimated effect size. As a significant proportion of the control group received the intervention (as part of standard care), any potential measurable effect was diluted. The improvement seen in patients receiving intervention and the increase in reported exercise in both groups (possible Hawthorne effect) suggests that exercise prescription for ED patients may be beneficial.

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Effects of Passive Hydrotherapy WATSU (WaterShiatsu) in the Third Trimester of Pregnancy: Results of a Controlled Pilot Study

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2015/437650 ◽

2015 ◽

Vol 2015 ◽

pp. 1-10 ◽

Cited By ~ 7

Author(s):

Agnes M. Schitter ◽

Marko Nedeljkovic ◽

Heiner Baur ◽

Johannes Fleckenstein ◽

Luigi Raio

Keyword(s):

Pilot Study ◽

Pregnant Women ◽

Qualitative Data ◽

Passive Control ◽

Intervention Group ◽

Treatment Method ◽

Control Group ◽

Third Trimester ◽

Therapeutic Benefits ◽

Negative Side Effects

Background. WATSU (WaterShiatsu) is a complementary therapeutic treatment method comprising passive stretches and massage techniques administered in 35°C warm water. Pregnant women claim safe methods to reduce pain, stress, and fatigue. Therefore, we conducted a pilot study evaluating the effects of WATSU on pregnancy-related complaints in third trimester pregnant women.Methods. Nine healthy pregnant women at gestational week ≥34 were included in an intervention group (receiving WATSU) and compared to eight women in a passive control group (receiving no treatment). WATSU was performed on days 1 and 4 of the study, accompanied by ultrasound examinations. Outcomes include physiological and psychometric as well as qualitative data. Participants in the control group completed questionnaires only.Results. WATSU was found to significantly lower participants’ levels of stress and pain and to improve their mental health-related quality of life and mood. In comparison to the passive control group, participants in the intervention group reported reduction in perceived stress from day 1 to day 8 (P=0.036, Cohen’sf=0.57). Qualitative data indicate that WATSU was appreciated as enjoyable and deeply relaxing. No negative side effects were reported.Conclusion. Our findings support the notion that WATSU yields therapeutic benefits for pregnant women and warrant further research. This study has been registered at ClinicalTrials.gov:NCT01708018.

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Child-Centred Health Dialogue for primary prevention of obesity in Child Health Services – a feasibility study

Scandinavian Journal of Public Health ◽

10.1177/1403494819891025 ◽

2019 ◽

pp. 140349481989102

Author(s):

Mariette Derwig ◽

Irén Tiberg ◽

Jonas Björk ◽

Inger Hallström

Keyword(s):

Primary Prevention ◽

Child Health ◽

Health Services ◽

Usual Care ◽

Feasibility Study ◽

Intervention Group ◽

Child Health Services ◽

Small Scale ◽

Control Group ◽

Health Dialogue

Aims: The aim of this study was to test a Child-Centred Health Dialogue model for primary prevention of obesity for 4-year-old children in Child Health Services, for its feasibility and the responsiveness of its outcomes. Methods: A feasibility study was set up with a non-randomised quasi-experimental cluster design comparing usual care with a structured multicomponent Child-Centred Health Dialogue consisting of two parts: (1) a universal part directed to all children and (2) a targeted part for families where the child is identified with overweight. Results: In total, 203 children participated in Child-Centred Health Dialogue while 582 children received usual care. Nurses trained in the model were able to execute both the universal health dialogue and the targeted part of the intervention. Tutorship enabled the nurses to reflect on and discuss their experiences, which strengthened their confidence and security. One year after the intervention fewer normal-weight 4-year-olds in the intervention group had developed overweight at the age of five compared with the control group, and none had developed obesity. The difference in overweight prevalence at follow-up did not reach statistical significance. Conclusions: This study demonstrates that a child-centred, multicomponent, interactive intervention for the promotion of healthy lifestyles and primary prevention of obesity for all 4-year-old children participating in Child Health Services is feasible on a small scale. As almost all caregivers make use of Child Health Services in Sweden, the findings should be confirmed in a randomised controlled trial before the intervention can be implemented on a larger scale.

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THE EFFECT OF THERAPEUTIC GROUP THERAPY ON THE DEVELOPMENT OF ADOLESCENT SELF IDENTITY IN ORPHANAGE

Journal of Vocational Nursing ◽

10.20473/jovin.v1i1.19917 ◽

2020 ◽

Vol 1 (1) ◽

pp. 86

Author(s):

Siti Kholifah ◽

Hendy Muagiri Margono ◽

Rizki Fitryasari ◽

Ah Yusuf , ◽

Hanik Endang ◽

...

Keyword(s):

Group Therapy ◽

Health Workers ◽

Negative Impact ◽

Intervention Group ◽

Identity Status ◽

Control Group ◽

Therapeutic Group ◽

Control Group Design ◽

Significance Level ◽

Self Identity

Introduction: Adolescents living in orphanages experience a lack of self-confidence, withdrawal, lack of interest in learning, lack of communication, and a closed attitude so that it will have a negative impact on cognitive, emotional, and social development. This study aims to determine the effect of Therapeutic Group Therapy (TKT) on the development of adolescent self-identity in orphanages. Methods : The study design was a Quasy experimental pre-post test control group design. The population was 104 children living in orphanages A and B. The research sample was 30 intervention groups and 32 control groups that met the inclusion criteria obtained through purposive sampling. The independent variable is Therapeutic Group Therapy while the dependent variable is self-identity. Data obtained using a questionnaire and analyzed using the Wilcoxon Sign Ranks Test and Mann-Whitney U Test with a significance level ∝ <0.05. Results : The results of the analysis of the intervention group showed the effect of TKT on self-identity (p = 0.0001). The results of the Mann-Whitney U Statistical Test of self-identity test showed a value of p = 0,0001 ( ∝ <0.05) meaning that there was an effect of TKT on self-identity between the two groups. Conclusion : TKT is done by health workers can help identify identity status teenagers and can improve self-identity teenager who lived in the orphanage through health education.

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