scholarly journals Meditation as an Intervention for Health: A Framework for Understanding Meditation Research

2019 ◽  
Author(s):  
Marcel Allbritton ◽  
Carrie Heeter
Keyword(s):  
Healthcare Professionals ◽  
Health Interventions ◽  
Meditation Practice ◽  
Scientific Rigor ◽  
Yoga Therapy ◽  
Individual Object ◽  
Essential Components ◽  
Object Experience ◽  
Published Research

We propose a framework for understanding meditation that can support greater scientific rigor in reporting meditation research, and selecting meditation health interventions. There is no consistent and thorough framework for describing meditation research interventions. This impedes rigor of meditation research design and interpretation of findings. This also limits meaningful comparisons across research studies. The audience for this article includes researchers, meditation experts, healthcare professionals, and those with interest in meditation. The framework describes the key components of a meditation intervention. We also discuss how meditation can effect individuals differently, and provide suggestions for describing the qualifications of the expert who designed the meditations in an intervention. The meditation framework supports (1) comparing different meditation interventions, and (2) understanding how meditation interventions lead to outcomes. We provide examples from a Yoga Therapy perspective of meditation (our domain of expertise), and from published research on meditation to illustrate applications of the meditation framework. The meditation framework provides a way of characterizing meditation interventions by distinguishing seven essential components. The first four components describe the meditation session (individual, object, experience, and immediate effects). Approach describes the foundation and source of a meditation practice. The outcome component represents both intended goals or reasons for prescribing the meditation intervention and other longer term effects that may occur. The engagement component refers to duration, spacing and frequency of doing the practice and quality of attention. These seven components can be applied to any type of meditation intervention. We explain the components of the framework and then offer examples. Our goal is to express the importance of having a framework for describing components of meditation across systems of knowledge and methods of application. We hope this article begins a dialogue with experts in other forms of meditation interventions, as they apply, adapt and respond to the proposed framework.

Foot health educational interventions for patients and healthcare professionals: A scoping review

2019 ◽  
Vol 79 (4) ◽  
pp. 390-416 ◽  
Author(s):  
Minna Stolt ◽  
Heidrun Gattinger ◽  
Carina Boström ◽  
Riitta Suhonen
Keyword(s):  
Scoping Review ◽  
English Language ◽  
Healthcare Professionals ◽  
Educational Interventions ◽  
Health Interventions ◽  
Foot Care ◽  
Foot Health ◽  
Patients With Diabetes ◽  
Reported Data

Objective: The aim of this scoping review was to examine educational foot health interventions tested with patients and healthcare professionals, with the ultimate goal of improving the quality of foot healthcare by identifying effective educational interventions for foot health. Design: Scoping review. Method: Three electronic databases (Medline/PubMed, CINAHL and Embase) were searched from citations up to 31 March 2019 within the limits of English language at the title and abstract level to identify foot health interventions. In total, 36 full texts found out of 762 citations were included in the review. Studies were eligible for inclusion if they were empirical, research-based intervention studies in which educational interventions with foot health content were conducted with a sample of adult patients and/or healthcare professionals, and foot health outcomes were reported. Data were analysed by summarising and categorising the studies and interventions. Critical appraisal tools from the Joanna Briggs Institute were used to evaluate the quality of the reviewed studies. Results: The educational foot health interventions reviewed were delivered in multiple forms, most often including a lecture, and were conducted individually or in small groups targeting predominantly patients with diabetes. The main content of the interventions was foot self-care. The interventions had positive outcomes for foot health, foot care knowledge, foot care activities and lower limb functional ability. Conclusion: This review identified many educational foot health interventions focused mainly on patients with diabetes. All these interventions have the potential to promote foot health in patients, and their future use and development is recommended.

QUALITY OF INDIVIDUAL AND GROUP LEVEL INTERVENTIONS FOR FIRST EPISODE PSYCHOSIS AT THE TERTIARY PSYCHIATRIC HOSPITAL IN UGANDA.

2020 ◽  
Author(s):  
Emmanuel Kiiza Mwesiga ◽  
Noeline Nakasujja ◽  
Lawrence Nankaba ◽  
Juliet Nakku ◽  
Seggane Musisi
Keyword(s):  
Psychiatric Hospital ◽  
Psychotic Disorders ◽  
First Episode Psychosis ◽  
First Episode ◽  
Group Level ◽  
Group Interventions ◽  
Episode Psychosis ◽  
Essential Components ◽  
The Individual

Introduction: Individual and group level interventions have the largest effect on outcomes in patients with the first episode of psychosis. The quality of these individual and group level interventions provided to first-episode psychosis patients in Uganda is unclear.Methods: The study was performed at Butabika National Psychiatric Teaching and referral hospital in Uganda. A retrospective chart review of recently discharged adult in-patients with the first episode of psychosis was first performed to determine the proportion of participants who received the different essential components for individual and group level interventions. From the different proportions, the quality of the services across the individual and group interventions was determined using the first-Episode Psychosis Services Fidelity Scale (FEPS-FS). The FEPS-FS assigns a grade of 1-5 on a Likert scale depending on the proportion of patients received the different components of the intervention. Results: The final sample included 156 first-episode psychosis patients. The median age was 27 years [IOR (24-36)] with 55% of participants of the female gender. 13 essential components across the individual and group interventions were assessed and their quality quantified. All 13 essential components had poor quality with the range of scores on the FEPS-FS of 1-3. Only one essential component assessed (use of single antipsychotics) had moderate quality.Discussion: Among current services at the National psychiatric hospital of Uganda, the essential for individual and group level interventions for psychotic disorders are of low quality. Further studies are required on how the quality of these interventions can be improved.

scholarly journals A Systematic Review of Healthcare Professionals’ Knowledge, Self-Efficacy and Attitudes Towards Working with Autistic People

2021 ◽  
Author(s):  
Kirsten Corden ◽  
Rebecca Brewer ◽  
Eilidh Cage
Keyword(s):  
Health Professionals ◽  
Self Efficacy ◽  
Healthcare Professionals ◽  
Assessment Tool ◽  
Vital Role ◽  
Narrative Synthesis ◽  
Quality Assessment Tool ◽  
Professional Background ◽  
Autistic People

AbstractHealthcare professionals play a vital role in identifying and supporting autistic people. This study systematically reviewed empirical research examining healthcare professionals’ knowledge, self-efficacy and attitudes towards working with autistic people. Thirty-five studies were included. The included studies sampled a range of countries and professional backgrounds. A modified quality assessment tool found the quality of the included studies was moderately good. Narrative synthesis indicated that healthcare professionals report only moderate levels of autism knowledge and self-efficacy, and often lack training. Variation within and between countries and professional background was not explained by demographic factors. The reviewed evidence suggests health professionals’ limited knowledge and self-efficacy in working with autistic people is a challenge to the provision of healthcare for autistic individuals.

scholarly journals Yoga therapy to reduce fatigue in cancer: effects of reminder e-mails and long-term efficacy

2021 ◽  
Author(s):  
Teresa Zetzl ◽  
Andre Pittig ◽  
Agnes Renner ◽  
Birgitt van Oorschot ◽  
Elisabeth Jentschke
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Mediation Model ◽  
Long Term Effects ◽  
Long Term Outcomes ◽  
Cognitive Fatigue ◽  
Yoga Therapy ◽  
Life Data

Abstract Objective To examine the efficacy of reminder e-mails to continue yoga therapy on practice frequency and fatigue in cancer patients and long-term effects of yoga on fatigue, depression, and quality of life. Methodology One hundred two cancer patients who completed an 8-week yoga therapy were randomly allocated to two groups: reminder (N = 51) vs. no-reminder group (N = 51). After completing yoga therapy, the reminder group received weekly e-mails for 24 weeks, which reminded them of practicing yoga, whereas the no-reminder group did not. Primary outcomes were fatigue and practice frequency, and long-term outcomes were fatigue, depression, and quality of life. Data were assessed using questionnaires after yoga therapy (T1) and 6 months after completing yoga therapy (T2). Result A significantly stronger reduction of general (p = 0.038, d = 0.42) and emotional fatigue (p = 0.004, d = 0.59) and a higher increase of practice frequency (p = 0.015, d = 0.52) between T1 and T2 were found for the reminder group compared to the no-reminder group. In the mediation model, practice frequency as a mediator partially explained the changes in emotional fatigue (indirect effect B =  − 0.10). Long-term effects of yoga therapy regarding fatigue, depression, and quality of life were found (F > 7.46, p < 0.001, d > 0.54). Conclusion Weekly reminder e-mails after yoga therapy can positively affect general and emotional fatigue and help cancer patients with fatigue establish a regular yoga practice at home. However, higher practice frequency did not lead to higher physical or cognitive fatigue improvement, suggesting other factors that mediate efficacy on physical or cognitive fatigue, such as mindfulness or side effects of therapy.

scholarly journals What methods and challenges for taking account of context when transferring complex interventions?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Villadsen ◽  
S Dias
Keyword(s):  
Public Health ◽  
Health Care ◽  
Reproductive Health ◽  
Health Care Providers ◽  
Complex Interventions ◽  
Health Interventions ◽  
Care Providers ◽  
Public Health Interventions ◽  
Reproductive Health Care

Abstract For complex public health interventions to be effective their implementation needs to adapt to the situation of those implementing and those receiving the intervention. While context matter for intervention implementation and effect, we still insist on learning from cross-country comparison of implementation. Next methodological challenges include how to increase learning from implementation of complex public health interventions from various context. The interventions presented in this workshop all aims to improve quality of reproductive health care for immigrants, however with different focus: contraceptive care in Sweden, group based antenatal care in France, and management of pregnancy complications in Denmark. What does these interventions have in common and are there cross cutting themes that help us to identify the larger challenges of reproductive health care for immigrant women in Europe? Issues shared across the interventions relate to improved interactional dynamics between women and the health care system, and theory around a woman-centered approach and cultural competence of health care providers and systems might enlighten shared learnings across the different interventions and context. Could the mechanisms of change be understood using theoretical underpinnings that allow us to better generalize the finding across context? What adaption would for example be needed, if the Swedish contraceptive intervention should work in a different European setting? Should we distinguish between adaption of function and form, where the latter might be less important for intervention fidelity? These issues will shortly be introduced during this presentation using insights from the three intervention presentations and thereafter we will open up for discussion with the audience.

scholarly journals Palliative care and complex chronic conditions since the perspective of healthcare professionals

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Doñate-Martínez ◽  
L Llop ◽  
J Garcés
Keyword(s):  
Primary Care ◽  
Palliative Care ◽  
Early Identification ◽  
Chronic Conditions ◽  
Healthcare Professionals ◽  
Care Pathway ◽  
Holistic View ◽  
Complex Chronic Conditions ◽  
Symptom Intensity

Abstract Background According to the WHO, palliative care (PC) is applicable early in the course of illness together with other curative therapies. Early PC has demonstrated beneficial effects on quality of life and symptom intensity among cancer patients. However, PC is not as early integrated on the care pathway of complex chronic conditions (CCC). This abstract presents barriers and needs identified to effectively implement early PC on CCC performed under the EU-funded InAdvance project (ref.: 825750). Methods Semi-structured interviews were performed with 16 healthcare professionals (HPs) from primary care and hospital settings working with older patients with CCC in Valencia (Spain). Results Interviews reported that main needs identified to provide early PC are: (a) coordinated strategies between multi-setting HPs to an early identification of CCC patients in need of PC; (b) adequate resources to attend patients' PC needs from a holistic view, i.e. psychosocial and spiritual needs; and (c) early integration of basic PC at primary care teams. The main barriers identified were: (a) stereotypes associated to the traditional PC approach; (b) poor knowledge from HPs of the PC holistic approach; and (c) lack of specific protocols or pathways for CCC in need of PC. Conclusions Specific skills and resources are the most relevant needs to effectively provide early PC among patients with CCC. First, it is urgent to demystify the negative culture-related vision of PC that is commonly associated to sedation and last days of a person's life. Also, multidisciplinary HPs require specific training to identify and provide early PC tailored to CCC. And, it is required a strategic and multi-setting organizational approach with fluent information flow and coordinated roles. Key messages Healthcare expenditure would be considerably reduced, especially at hospital and emergency units, with an early identification of patients with CCC in need of PC. Empowering primary HPs in PC would improve the quality of care of patients with CCC.

Dyspareunia

2021 ◽  
pp. 175573802110302
Author(s):  
Charlotte Morris ◽  
Catherine Briggs ◽  
Manju Navani
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Healthcare Professionals ◽  
Persistent Pain ◽  
Differential Diagnoses ◽  
Relationship Problems

Dyspareunia is persistent pain on attempted or successful vaginal penetration. It is under-reported, infrequently asked about by healthcare professionals, and affects quality of life and relationships. Dyspareunia is multifactorial and possesses biopsychosocial components. Pain may be distinct and localised, deep or persistent. Among the symptoms, women describe sensations of aching, throbbing and tearing. Disinterest in sex and relationship problems can result. This article discusses dyspareunia, its common differential diagnoses and aims to improve clinician confidence in assessing and managing dyspareunia in primary care.

scholarly journals Quality of Life Prior and in the Course of the COVID-19 Pandemic: A Nationwide Cross-Sectional Study with Brazilian Dietitians

2021 ◽  
Vol 18 (5) ◽  
pp. 2712
Author(s):  
Raquel Adjafre da Costa Matos ◽  
Rita de Cassia Coelho de Almeida Akutsu ◽  
Renata Puppin Zandonadi ◽  
Raquel Braz Assunção Botelho
Keyword(s):  
Quality Of Life ◽  
Psychological Health ◽  
Social Relationship ◽  
Healthcare Professionals ◽  
Life Quality ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Chi Squared

Dietitians as healthcare professionals could decrease their quality of life during the SARS-COV-2 pandemic period; therefore, this study aimed to compare Brazilian dietitians’ perceptions of quality of life before and during the pandemic. This nationwide cross-sectional research aimed to evaluate Brazilian dietitians’ quality of life before and in the course of the COVID-19 pandemic, using a previously validated self-administered instrument WHO-QOL-BREF in Brazilian-Portuguese. The questionnaire was composed of 26 items (four domains) to evaluate life quality (physical, psychological, social relationship, and environment). The questionnaire also presented some sociodemographic variables and three questions about the COVID-19 pandemic. It was applied using GoogleForms® platform (Google LLC, Mountain View, CA, USA). For the statistical analysis of data, Paired T-test, Chi-squared test, and Analysis of Variance were used. A total of 1290 Brazilian dietitians replied to the instrument. Comparing quality of life (QoL) before SARS-COV-2 (3.83 ± 0.59) and during the pandemic (3.36 ± 0.66), data was statistically different. Comparing prior and in the course of the COVID-19 pandemic, all variables and domains presented statistical differences (better before the pandemic period). Among Brazilian dietitians, the psychological health domain was the most affected. The Sars-Cov-2 pandemic negatively impacted the QoL of Brazilian dietitians since health professionals face changes in their lives because of work.

Medicare’s Hospital Value-Based Purchasing Program Values Quality over QALYs

2021 ◽  
pp. 0272989X2110171
Author(s):  
Edward C. Norton ◽  
Jun Li ◽  
Anup Das ◽  
Andrew M. Ryan ◽  
Lena M. Chen
Keyword(s):  
Quality Of Care ◽  
Pay For Performance ◽  
Health Interventions ◽  
Quality Adjusted Life Years ◽  
Value Based Purchasing ◽  
Quality Performance ◽  
Life Years ◽  
Policy Adjustments ◽  
Quality Adjusted Life

Medicare’s Hospital Value-Based Purchasing Program (HVBP) is the first national pay-for-performance program to combine measures of quality of care with a measure of episode spending. We estimated the implicit tradeoffs between mortality reduction and spending reduction. To earn points in HVBP, a hospital can either lower mortality or reduce spending, creating a tradeoff between the 2 measures. We analyzed the quality performance and earned points of 2814 hospitals using publicly available data. We then quantified the tradeoffs between spending and mortality in terms of quality-adjusted life-years (QALYs). If incentives in the program were balanced, then the tradeoff between spending and QALYs should be comparable with those of high-value health interventions, roughly $50,000 to $200,000 per QALY. Instead, the tradeoff in HVBP was about $1.2 million per QALY. HVBP overvalues improvements in quality of care relative to spending reductions. We propose 2 possible policy adjustments that could improve incentives for hospitals to deliver high-value care.

scholarly journals The impact of e-Health interventions on promoting Self-Care in Chronic Patients: an Umbrella Review

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Renzi ◽  
G Gasperini ◽  
V Baccolini ◽  
C Marzuillo ◽  
C De Vito ◽  
...  
Keyword(s):  
Public Health ◽  
Quality Of Life ◽  
Chronic Conditions ◽  
Self Care ◽  
Health Interventions ◽  
Self Management ◽  
Improve Quality ◽  
Umbrella Review ◽  
Copd Patients

Abstract Background Promoting self-care is one of the most promising strategies to manage people with chronic conditions and to improve the Public Health System resilience. In this context, the use of e-Health could facilitate self-care promotion, assure continuity of care and save time. Methods We performed an umbrella review on Cochrane, Scopus, Medline, PsychInfo, CINAHL to analyse e-Health self-care promoting intervention in patients with Type- 2 Diabetes Mellitus (T2DM), Cardiovascular Diseases (CVD) and Chronic Obstructive Pulmonary Disease (COPD) compared to traditional intervention. AMSTAR-2 was used for quality appraisal. Results 10 systematic reviews were included for an amount of 376 RCTs and 3 quasi-experimental studies. All the e-Health interventions retrieved were categorized in 4 subgroups: Phone Reminder, Telemonitoring, Psychoeducational intervention supported by PCs/Apps and Combined Intervention. Nurses (271/379 studies) and physicians (149/379 studies) were the healthcare workers mostly involved in the administration of e-Health interventions. T2DM (5 reviews; 175 studies) and CVD (7 reviews; 164 studies) patients gained more progresses in self-management than COPD patients (3 reviews; 8 studies). E-Health appeared effective both in promoting self-management and disease awareness. Globally, all the e-Health interventions seemed to improve Quality of Life and clinical outcomes. Phone reminders were most effective to increase Medication Adherence. All Causes Mortality registered a positive effect through Telemonitoring. Hospital Admission and Cost-Efficacy were explored only by telemonitoring and it did not show differences with traditional intervention. Conclusions E-Health is an effective strategy to promote self-care in patients with chronic conditions and to improve quality of life and clinical outcomes. Further research is required to test e-Health intervention in COPD patients and to examine if there is different efficacy among e-Health subgroups. Key messages E-Health should be integrated in Primary Care strategies to improve Public Health systems resilience. Nurses, as frontline Primary Health Care workers, should be advised for e-Health administration.

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