Brief Report on the Outcomes of an Integrated Approach on Stress, Anxiety, and Persistent Pain for Veterans; Mindful Yoga and Auricular Acupuncture

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Brosmer J ◽  
◽  
Gibson J ◽  
Keyword(s):  
Mental Health ◽  
Perceived Stress ◽  
Integrated Treatment ◽  
Persistent Pain ◽  
Small Sample ◽  
Mental Health Provider ◽  
Auricular Acupuncture ◽  
Acupuncture Points ◽  
Post Intervention ◽  
Sample Mean

Objective: The aim of this study was to pilot test an integrated treatment approach, including mindful yoga and auricular acupuncture, for Veterans with overlapping mental health disorders and persistent pain. Design: A single-arm, quasi-experimental study with a 12-week intervention period. Methods: Veterans were referred to the program through their established mental health provider, which was marketed as a trauma sensitive mindful yoga program with optional auricular acupuncture for Veterans currently undergoing mental health treatment. The program consisted of 12 weekly 90-minute group yoga sessions that included mindful breathing, mindful movement, and guided relaxation. Auricular acupuncture was also offered but not required prior to each yoga session, where five acupuncture points were targeted for relaxation and stress relief. Stress, pain, and anxiety were assessed pre and post intervention using the Perceived Stress Scale, the PEG scale, and the Generalized Anxiety Disorder-7 Scale. Results: Out of fifty-five Veterans entering the program with a mental health diagnosis, twenty-seven Veterans completed the 12-week Mindful Yoga program. For those that completed the program, the average attendance was 9.5 out of 12 sessions. Means scores show improvement in perceived stress, pain, and anxiety compared with baseline scores. Statistically significant improvements were noted in both perceived stress (P = 0.0007) and anxiety (P = 0.0093). Conclusions: This study suggests that combining mindful yoga with auricular acupuncture can reduce symptoms of stress, pain, and anxiety in Veterans that commit to the program. Although this was a small sample, mean scores showed statistically significant improvements in perceived stress and anxiety and modest improvements in pain, warranting further study.

Supporting mental health during COVID-19 using a digital behaviour change intervention: an open-label, single-arm, pre-post intervention research study (Preprint)

2021 ◽  
Author(s):  
Charlotte Summers ◽  
Philip Wu
Keyword(s):  
Mental Health ◽  
Behaviour Change ◽  
Perceived Stress ◽  
Digital Health ◽  
Mental Wellbeing ◽  
Behaviour Change Intervention ◽  
Open Label ◽  
Post Intervention ◽  
Convenience Sample ◽  
Health Technologies

BACKGROUND COVID-19 is taking its toll on people's mental health, particularly as people are advised to adhere to social distancing, self-isolation measures and government imposed national lockdowns. Digital health technologies have an important role to play in keeping people connected and supporting mental health and wellbeing. Particularly in the wake of the COVID-19 pandemic as even before this unprecedented time, mental health and social services were already stretched. OBJECTIVE Our objective was to evaluate the 12-week outcomes of the digitally delivered Gro Health platform, a digital behaviour change intervention for self-management of mental wellbeing, sleep, activity, and nutrition. METHODS The study used a quasi-experimental research design consisting of an open-label, single-arm, pre-post intervention engagement using a convenience sample. From adults who had joined the intervention and had a complete baseline dataset (GAD-7 Anxiety Test Questionnaire, Perceived Stress Scale, PHQ-9 Patient Health Questionnaire), we followed all users for 12 weeks (N=273), including 33 (12.1%) who reported a positive COVID-19 diagnosis during the study period. Users engagement with the Gro Health platform was tracked by active minutes. RESULTS Of the 347 study participants, 273 (78.67%) completed both baseline and follow up surveys. Change in scores for anxiety, perceived stress and depression was predicted by app engagement with the strongest effect being seen in change perceived stress scores F(1,271)=251.397, p<0.001, with an R2 of .479. CONCLUSIONS A digital behaviour change platform that provides remote mental wellbeing support can be effective in managing depression, anxiety, and perceived stress during times of crisis such as the current COVID-19 pandemic. CLINICALTRIAL Approved by Royal Holloway, University of London Ethics Board.

Acceptability and Feasibility of a Computerized Cognitive Behavioral Therapy Intervention for Depression among Veterans (Preprint)

2021 ◽  
Author(s):  
Kelly A Stearns-Yoder ◽  
Arthur T Ryan ◽  
Alexandra A Smith ◽  
Jeri E Forster ◽  
Sean M Barnes ◽  
...  
Keyword(s):  
Mental Health ◽  
Behavioral Therapy ◽  
Medical Center ◽  
Military Veterans ◽  
Cognitive Behavioral ◽  
Mental Health Provider ◽  
Post Intervention ◽  
Empirically Supported ◽  
Us Military ◽  
Behavioral Therapies

BACKGROUND Computerized cognitive behavioral therapies (cCBT) have been developed to deliver efficient, evidence-informed treatment for depression and other mental health conditions. One of the most empirically supported cCBTs for depression is Beating the Blues (BtB), which is often administered with the support of a care provider or peer. This increases the complexity and cost of the intervention. OBJECTIVE Researchers at a Veterans Affairs Medical Center (VAMC) aimed to test the acceptability and feasibility stand-alone cCBT for depression among US military Veterans. METHODS Among United States (US) military Veterans experiencing current mild to moderate depressive symptoms, a before-after trial was implemented to examine the acceptability of BtB delivered without additional peer or other mental health provider support. Feasibility of the study design for use in a future efficacy trial was also evaluated. RESULTS Forty-nine Veterans completed pre-intervention assessments and received access to BtB. Twenty-nine participants completed all post-intervention assessments. Thresholds for acceptability of the intervention were met. While pre-determined feasibility criterion regarding eligibility, use of BtB, and post-assessment completion were not met, results were comparable with other cCBT studies. CONCLUSIONS This study is the first among US military Veterans to demonstrate support for implementation of a cCBT for depression without the assistance of a mental health professional or a peer support specialist; thereby suggesting that a stand-alone computer-aided intervention may be viable. Further research is warranted. CLINICALTRIAL N/A

scholarly journals Enhancing Health Through Access to Nature: How Effective are Interventions in Woodlands in Deprived Urban Communities? A Quasi-experimental Study in Scotland, UK

2019 ◽  
Vol 11 (12) ◽  
pp. 3317 ◽  
Author(s):  
Catharine Ward Thompson ◽  
Aldo Elizalde ◽  
Steven Cummins ◽  
Alastair H. Leyland ◽  
Willings Botha ◽  
...  
Keyword(s):  
Mental Health ◽  
Community Engagement ◽  
Perceived Stress ◽  
Green Space ◽  
Landscape Planning ◽  
Public Health Problem ◽  
Natural Environments ◽  
Major Public Health Problem ◽  
Post Intervention

High prevalence of poor mental health is a major public health problem. Natural environments may contribute to mitigating stress and enhancing health. However, there is little evidence on whether community-level interventions intended to increase exposure to natural environments can improve mental health and related behaviours. In the first study of its kind, we evaluated whether the implementation of a programme designed to improve the quality of, and access to, local woodlands in deprived communities in Scotland, UK, was associated with lower perceived stress or other health-related outcomes, using a controlled, repeat cross-sectional design with a nested prospective cohort. Interventions included physical changes to the woodlands and community engagement activities within the woodlands, with data collected at baseline (2013) and post-intervention (2014 and 2015). The interventions were, unexpectedly, associated with increased perceived stress compared to control sites. However, we observed significantly greater increases in stress for those living >500 m from intervention sites. Visits to nearby nature (woods and other green space) increased overall, and moderate physical activity levels also increased. In the intervention communities, those who visited natural environments showed smaller increases in stress than those who did not; there was also some evidence of increased nature connectedness and social cohesion. The intervention costs were modest but there were no significant changes in quality of life on which to base cost-effectiveness. Findings suggest factors not captured in the study may have contributed to the perceived stress patterns found. Wider community engagement and longer post-intervention follow-up may be needed to achieve significant health benefits from woodland interventions such as those described here. The study points to the challenges in evidencing the effectiveness of green space and forestry interventions to enhance health in urban environments, but also to potential benefits from more integrated approaches across health and landscape planning and management practice.

P191 The effectiveness of mindfulness-based interventions on perceived stress, depression and anxiety in patients with coronary heart disease: A systematic review and meta-analysis

2020 ◽  
Vol 41 (Supplement_1) ◽  
Author(s):  
H Zou ◽  
S Y Chair ◽  
X Cao
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Active Control ◽  
Perceived Stress ◽  
Psychological Health ◽  
Meta Analysis ◽  
Small Sample ◽  
Significant Heterogeneity ◽  
Depression And Anxiety ◽  
Post Intervention

Abstract Background An increasing number of people are living with coronary heart disease (CHD) globally. Psychological conditions such as stress, depression, and anxiety are prevalent for people with CHD, which impose a great challenge for secondary prevention of CHD. Mindfulness-based interventions (MBIs), which incorporate mindfulness skills and cognitive or behavioural therapy, are suggested as a promising approach to help patients with CHD to improve their psychological health. However, the effectiveness of MBIs for patients with CHD has not been systematically reviewed. Purpose To synthesise the evidence regarding the effects of MBIs on reducing perceived stress, depression, and anxiety in patients with CHD. Methods   Search was conducted in seven English electronic databases and two Chinese electronic databases from inception to January 2019. Randomized controlled trials (RCTs) that evaluated the effects of MBIs on stress, depression, and anxiety in adults with CHD were included. Two reviewers independently screened records for eligibility, extracted data, and assessed risks of bias using the Cochrane tool. Meta-analysis was conducted by combining the standard mean difference (SMD) with 95% confidence interval (CI) of post-intervention outcome measures using Review Manager Version 5.3. We used a fixed-effects model if no significant heterogeneity (I² &lt; 50%), while in case of significant heterogeneity (50% &lt; I² &lt; 75%), we used a random-effects model. Results Six RCTs involving 473 participants were included. Five of all studies compared MBIs with inactive controls (i.e., usual care and waitlist control). The remaining study utilized a self-help group that received a booklet containing identical mindfulness information as an active control. There were high concerns about the risk of bias across studies, mainly in performance bias and detection bias. The meta-analysis of two studies showed MBIs may reduce perceived stress at post-intervention (SMD -0.82; 95% CI -1.28 to -0.36; P &lt; 0.001; I² 0%) compared with inactive controls. Compared with active control, the single study did not observe a significant reduction of perceived stress in intervention group. The meta-analysis of five studies revealed that MBIs appear effective in reducing depression (SMD -1.08; 95% CI -1.28 to -0.87; P &lt; 0.001; I² 22%) and anxiety (SMD -1.16; 95% CI -1.57 to -0.75; P &lt; 0.001; I² 71%) immediately after intervention, compared with inactive or active controls. Conclusions The results of this review provide evidence for the effects of MBIs on reduction in perceived stress, depression and anxiety at post-intervention in patients with CHD. However, these findings need to be interpreted with caution given the small sample size and methodological limitations within included studies. Rigorous-designed research is urgently needed to further confirm the effectiveness of MBIs on improving psychological health and explore its sustainable effects in patients with CHD.

scholarly journals Screening for Diabetes-Related Distress in an Outpatient Endocrine Clinic

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A475-A476
Author(s):  
Jheneale Renee Grandison ◽  
Kimberly Callender ◽  
Barbara Mensah Onumah
Keyword(s):  
Mental Health ◽  
Diabetes Management ◽  
Short Form ◽  
Practice Change ◽  
Mental Health Provider ◽  
Mental Health Providers ◽  
Health Providers ◽  
Post Intervention ◽  
Implementation Phase ◽  
Referral Compliance

Abstract Background: Identification and treatment of diabetes-related distress (DD) are essential for diabetes management, quality of life, and reducing health care costs for people with diabetes. There is no standardized workflow for DD screening in an outpatient endocrine clinic that manages approximately 2000 persons with diabetes. Aim: This quality improvement (QI) project aims to implement a DD screening and referral program in an outpatient endocrine clinic. Methods: The Mobilize, Assess, Plan, Implement, Track (MAP-IT) model was used to design the QI project. Patients without a diagnosis of diabetes, age less than 18 years, and pregnant women were excluded from the screening. DD was measured using the Problem Areas in Diabetes-5 (PAID-5) scale (0 - 20) points (1). An ambulatory systems analyst created a flowsheet in Epic for the PAID-5 questionnaire and routed the PAID-5 to MyChart. During the implementation phase, patients completed the PAID-5 on MyChart one week before their appointment or in-person during the encounter. Providers referred patients with a PAID-5 score ≥ 8 to a mental health provider (MHP). The primary outcomes were PAID-5 screening compliance and mental health referral compliance. Secondary outcomes include PAID-5 scores and hemoglobin A1C value percentage; changes in the PAID-5 scores and A1C values were compared pre- and post-intervention. Results: The project was implemented on August 31st, 2020. As of October 29th, 2020, the PAID-5 screening compliance was 66% (n = 385/585). The patient sample was 57% female and 43% male. It was identified that 113 (29%) patients had a PAID-5 score ≥ 8. Of these, only 33 (29%) patients received a referral to a MHP. Thirty-three patients (29%) refused a referral, and 5% were already seeing a MHP. Pre-intervention, the average PAID-5 score was 5, and the average baseline A1C value was 8% (&lt; 5.7%). Conclusion: Based on the preliminary data, screening for DD in adults with diabetes utilizing the PAID-5 questionnaire is feasible and can facilitate the referral of distressed patients to mental health providers. Long-term implications for the practice change include a holistic and comprehensive approach to the management of diabetes and diabetes-related outcomes, including reduction of PAID-5 scores and A1C values in individuals referred to a MHP. References: (1) McGuire, B. E., Morrison, T. G., Hermanns, N., Skovlund, S., Eldrup, E., Gagliardino, J., Kokoszka, A., Mathews, D., Pibernik, M., Rodriguez, J., Wit, M., & Snoek, F. J. (2010). Short-form measures of diabetes-related emotional distress: The Problem Areas in Diabetes Scale (PAID)-5 and PAID-1. Diabetologia, 53(1), 66–69. https://doi.org/10.1007/s00125-009-1559-5

scholarly journals Mental Health in Patients With Adrenal Incidentalomas: Is There a Relation With Different Degrees of Cortisol Secretion?

2020 ◽  
Vol 106 (1) ◽  
pp. e130-e139
Author(s):  
Valentina Morelli ◽  
Alberto Ghielmetti ◽  
Alice Caldiroli ◽  
Silvia Grassi ◽  
Francesca Marzia Siri ◽  
...  
Keyword(s):  
Mental Health ◽  
Perceived Stress ◽  
Verbal Fluency ◽  
Rating Scale ◽  
Adrenal Incidentaloma ◽  
Integrated Treatment ◽  
Subclinical Hypercortisolism ◽  
Tower Of London ◽  
Disability Score ◽  
Neurocognitive Functions

Abstract Context Cushing’s syndrome frequently causes mental health impairment. Data in patients with adrenal incidentaloma (AI) are lacking. Objective We aimed to evaluate psychiatric and neurocognitive functions in AI patients, in relation to the presence of subclinical hypercortisolism (SH), and the effect of adrenalectomy on mental health. Design We enrolled 62 AI patients (64.8 ± 8.9 years) referred to our centers. Subclinical hypercortisolism was diagnosed when cortisol after 1mg-dexamethasone suppression test was &gt;50 nmol/L, in the absence of signs of overt hypercortisolism, in 43 patients (SH+). Interventions The structured clinical interview for the Diagnostic and Statistical Manual of Mental Disorders-5, and 5 psychiatric scales were performed. The Brief Assessment of Cognition in Schizophrenia (Verbal and Working Memory, Token and Symbol Task, Verbal Fluency, Tower of London) was explored in 26 patients (≤65 years). Results The prevalence of psychiatric disorders was 27.4% (SH+ 30.2% vs SH- 21.1%, P = 0.45). SH+ showed a higher prevalence of middle insomnia (by the Hamilton Depression Rating Scale) compared with SH- (51% vs 22%, P = 0.039). Considering the Sheehan Disability Scale, SH+ showed a higher disability score (7 vs 3, P = 0.019), higher perceived stress (4.2 ± 1.9 vs 2.9 ± 1.9, P = 0.015), and lower perceived social support (75 vs 80, P = 0.036) than SH-. High perceived stress was independently associated with SH (odds ratio [OR] = 5.46, confidence interval 95% 1.4–21.8, P = 0.016). Interestingly, SH+ performed better in verbal fluency (49.5 ± 38.9 vs 38.9 ± 9.0, P = 0.012), symbol coding (54.1 ± 6.7 vs 42.3 ± 15.5, P = 0.013), and Tower of London (15.1 vs 10.9, P = 0.009) than SH-. In 8 operated SH+, no significant changes were found. Conclusions Subclinical hypercortisolism may influence patients’ mental health and cognitive performances, requiring an integrated treatment.

scholarly journals The importance of formal versus informal mindfulness practice for enhancing psychological wellbeing and study engagement in a medical student cohort with a 5-week mindfulness-based lifestyle program

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0258999
Author(s):  
Naomi Kakoschke ◽  
Craig Hassed ◽  
Richard Chambers ◽  
Kevin Lee
Keyword(s):  
Mental Health ◽  
Medical Students ◽  
Perceived Stress ◽  
Mindfulness Practice ◽  
Psychological Wellbeing ◽  
First Year ◽  
Post Intervention ◽  
Change Scores ◽  
Stress Study ◽  
Study Engagement

Purpose Medical students commonly experience elevated psychological stress and poor mental health. To improve psychological wellbeing, a 5-week mindfulness-based lifestyle course was delivered to a first-year undergraduate medical student cohort as part of the core curriculum. This study investigated the effects of the program on mental health, perceived stress, study engagement, dispositional mindfulness, and whether any improvements were related to amount of formal and/or informal mindfulness practice. Methods Participants were first year undergraduate medical students (N = 310, 60% female, M = 18.60 years) with N = 205 individuals completing pre and post course questionnaires in a 5-week mindfulness-based lifestyle intervention. At pre- and post-intervention, participants completed the Mental Health Continuum-Short Form, the Perceived Stress Scale, the Utrecht Work Engagement Scale for Students, the Freiburg Mindfulness Inventory, and the Mindfulness Adherence Questionnaire. Results Mental health, perceived stress, study engagement, and mindfulness all improved from pre- to post-intervention (all p values < .001). Improvements on these outcome measures were inter-related such that PSS change scores were negatively correlated with all other change scores, FMI change scores were positively correlated with MHC-SF and UWES-S change scores, the latter of which was positively correlated with MHC-SF change scores (all p values < .01). Finally, observed improvements in all of these outcomes were positively related to informal practice quality while improved FMI scores were related to formal practice (all p values < .05). Conclusions A 5-week mindfulness-based program correlates with improving psychological wellbeing and study engagement in medical students. These improvements particularly occur when students engage in informal mindfulness practice compared to formal practice.

scholarly journals Look After Yourself: Students Consistently Showing High Resilience Engaged in More Self-Care and Proved More Resilient During the COVID-19 Pandemic

2021 ◽  
Vol 12 ◽  
Author(s):  
Laura E. Meine ◽  
Eike Strömer ◽  
Sandra Schönfelder ◽  
Eliza I. Eckhardt ◽  
Anna K. Bergmann ◽  
...  
Keyword(s):  
Mental Health ◽  
Perceived Stress ◽  
Latent Class ◽  
Small Sample Size ◽  
Real Life ◽  
Self Care ◽  
Extended Period ◽  
Small Sample ◽  
Resilience Factors ◽  
Underlying Mechanisms

The COVID-19 pandemic has prompted severe restrictions on everyday life to curb the spread of infections. For example, teaching at universities has been switched to an online format, reducing students' opportunities for exchange, and social interaction. Consequently, their self-reported mental health has significantly decreased and there is a pressing need to elucidate the underlying mechanisms—ideally considering not only data collected during the pandemic, but also before. One hundred seventeen German university students aged 18-27 were assessed for known resilience factors (optimism, self-care, social support, generalized self-efficacy) and subsequently completed surveys on stress experiences and mental health every 3 months over a period of 9 months before the outbreak of the pandemic and once during the first lockdown in Germany. For each timepoint before the pandemic, we regressed participants' mental health against the reported stressor load, such that the resulting residuals denote better or worse than expected outcomes, i.e., the degree of resilient functioning. We then tested whether different expressions in the resilience factors were predictive of distinct resilient functioning trajectories, which were identified through latent class growth analysis. Finally, we investigated whether trajectory class, resilience factors, and perceived stress predicted resilience during the pandemic. Results show rather stable resilient functioning trajectories, with classes differing mainly according to degree rather than change over time. More self-care was associated with a higher resilient functioning trajectory, which in turn was linked with the most favorable pandemic response (i.e., lower perceived stress and more self-care). Although findings should be interpreted with caution given the rather small sample size, they represent a rare examination of established resilience factors in relation to resilience over an extended period and highlight the relevance of self-care in coping with real-life stressors such as the pandemic.

The Resilience Enhancement Programme for Students (REP-S)

2022 ◽  
pp. 37-55
Author(s):  
Oliver Robinson ◽  
Ilham Sebah ◽  
Ana A. Avram
Keyword(s):  
Mental Health ◽  
Higher Education ◽  
Perceived Stress ◽  
Empirical Evaluation ◽  
Post Intervention ◽  
Online Delivery ◽  
Online Platform ◽  
Study Results ◽  
Quantitative Design ◽  
The University

The Resilience Enhancement Programme for Students (REP-S) is an intervention that has been designed to boost resilience in students. The current study involved the remote delivery of the REP-S via an online platform to students, and an empirical evaluation of the intervention via a pre-post one-group quantitative design over one month and a post-intervention qualitative element. Fifty-six students from the University of Greenwich qualified for inclusion in the study. Results indicated that perceived stress and trait neuroticism decreased over the month of the study, while resilience increased. Engagement with the intervention also predicted a reduction in neuroticism. Students reported experiencing a complex range of difficulties over the duration of the pandemic and that 80% of participants found the workshop to be effective in addressing these problems. Overall, participants found more positives than negatives in the online delivery of the workshop. If rolled out on a wider basis, the REP-S has the potential to improve wellbeing and mental health across the higher education sector.

The experiences of paid formal lived experience workers within a secure mental health service

2017 ◽  
Vol 12 (5) ◽  
pp. 313-322 ◽  
Author(s):  
Christopher A. Griffiths ◽  
Ella Hancock-Johnson
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Lived Experience ◽  
Service Use ◽  
Small Sample ◽  
Clinical Staff ◽  
Mental Health Provider ◽  
Content Type ◽  
Mental Health Settings

Purpose The purpose of this paper is to report the experience and impact of paid staff who are employed to use their lived experience of mental health issues and service use within a secure mental health provider. Design/methodology/approach A qualitative approach using semi-structured interviews and thematic analysis was employed. Findings Results from this study suggest that employing lived experience workers (LEWs) in secure mental health settings is valuable to clinical staff, service users, the employing organisation and LEWs themselves. Findings emphasised the importance of support for LEWs to enable them to fulfil their role and maintain wellbeing, and the need to consider LEWs career progression within and beyond the role. Research limitations/implications This study had a small sample size. Practical implications There is evidence to support LEWs in secure mental health settings and requirement for further understanding of their work in this environment. Specific recommendations include the need for training for clinical staff about the role of LEWs, specific LEWs role training, and regular supervision and mental health support for LEWs. Originality/value This is the first paper reporting the experience and impact of LEWs in a UK secure mental health service.

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