Effect of hope therapy on psychological well-being of women after abortion: a randomized controlled trial

Background Giving a healthy birth plays a vital role in a person’s personality development, but giving unhealthy birth and abortion can increase the risk of a range of mental disorders and psychological harms including reduced well-being and quality of life. Psychological interventions can reduce the problems of individuals, so the present study was conducted to evaluate the effect of counseling with hope therapy on psychological well-being (primary outcome) and quality of life (secondary outcome) of women with an experience of abortion. Method This randomized controlled trial was conducted in Alzahra and Taleghani educational and medical centers in Tabriz, Iran, on 52 women aged 16 years and above whose pregnancies led to abortion in 2020–21. Participants were assigned to intervention and control groups using random blocking method. The intervention group received counseling with hope therapy approach in 8 sessions of 45 min twice a week. The psychological well-being and WHO Quality of Life (WHOQOL) questionnaires were completed before the intervention and immediately and 4 weeks after the intervention. Independent t-test and repeated measures ANOVA were used to compare the outcomes in two groups. Results After the intervention based on the repeated measures ANOVA test and by adjusting the baseline score, the mean total score of psychological well-being in the counseling group was significantly higher than that in the control group (adjusted mean difference (AMD): 76.76; 95% confidence interval (95% CI): 63.81 to 89.70; P < 0.001). Also, the mean total score of quality of life in the counseling group was significantly higher than in the control group (AMD: 7.93; 95% CI: 6.38 to 9.46; P < 0.001). The mean score of all sub-domains of psychological well-being and quality of life in the counseling group was significantly higher than that in the control group (P < 0.05). Conclusion Using hope therapy can improve the psychological well-being and quality of life of women after abortion. However, further clinical trials are required before making a definitive conclusion. Trial registration Iranian Registry of Clinical Trials (IRCT): IRCT20120718010324N60. Date of registration: 17 Dec 2020. Date of first registration: 20 Dec 2020.

Feasibility of a randomized hypertension screening initiative in the perioperative setting

Objectives This study sought to assess feasibility of a randomized trial of blood pressure intervention (home blood pressure monitoring vs. counseling) in the preoperative clinic and the baseline rates of primary care follow-up after such interventions. Methods A prospective randomized feasibility study was performed at Yale New Haven Hospital Preadmission Testing Clinic. A sample of 100 adults, with elevated blood pressure, were recruited during their preadmission visit, and randomized 1:1 to receive brief BP counseling and an educational brochure versus additionally receiving a home BP monitor (HBPM) with a mailed report of their home readings. At 60-day post-surgery telephone follow-up, investigators asked whether participants had primary-care follow-up; had new/adjusted hypertension treatment; and felt satisfied with the study. Results There were 51 patients in the counseling group and 49 in the HBPM group. Of 46 patients in the HBPM group who returned their monitors, 36 (78%) were hypertensive at home. At 60 days post-surgery, 31 (61%) patients in the counseling group and 30 (61%) in the HBPM group were reached by telephone with the remaining followed by EHR. Thirty-six (71%) patients in the counseling group and 36 (73%) in the HBPM group had seen their primary care provider. Seventeen of 36 (47%) in the counseling group and 18 of 31 (58%) in the HBPM group received new or adjusted hypertension medications. Sixty-one participants answered questions regarding their satisfaction with the study with 52 (85%) reporting that they felt moderately to very satisfied. Conclusions This feasibility study suggests that interventional blood pressure trials in the preoperative clinic are feasible, but telephone follow-up leads to significant gaps in outcome ascertainment. Trial registration Clinicaltrials.gov, NCT03634813. Registered 16 of August 2018.

Role of Voice Therapy in Adherence to Voice Rest After Office-Based Vocal Fold Procedures

Purpose Patients undergoing vocal fold procedures significantly reduce but often do not cease voice use during absolute postprocedure voice rest. We hypothesized that patients who completed preprocedure voice therapy would increase adherence to postprocedure voice rest. Method Eighty-six participants completed this prospective cohort study. Patients scheduled for office-based vocal fold procedures, 1–3 days of absolute postprocedure voice rest, and preprocedure speech-language pathology (SLP) care were recruited. SLP care consisted of either (a) multiple voice therapy sessions, (b) one counseling/therapy session, or (c) voice evaluation only. Participants reported talking and other specific voice behaviors on 100-mm visual analog scales for up to 3 days pre- and postprocedure as well as changes in overall voice use at follow-up at least 1 week postprocedure. Results Talking decreased postprocedure by 63% in the therapy group and 65% in the counseling group, both significantly more than the 35% decrease measured in the evaluation group. There were group differences in talking at baseline but not during voice rest. Coughing and throat clearing were highest in the voice evaluation group and decreased less than talking during voice rest. At follow-up, 84% of participants reported that they completed voice rest for at least as long as recommended and 39.5% reported that they never used their voices during voice rest. Participants estimated a 98% overall reduction in voice use during voice rest at follow-up. Conclusions Voice use before and after vocal fold procedures varies by participation in preprocedure voice therapy. Patients significantly decrease talking during postprocedure voice rest but are not perfectly adherent. Communicative voice use decreases more than noncommunicative voice use during voice rest. Patients may overestimate adherence to voice rest at follow-up. Supplemental Material https://doi.org/10.23641/asha.16589864

Tinnitus Activities Treatment with Total and Partial Masking

Background There are many counseling and sound therapy approaches to treat tinnitus. Counseling approaches range from providing information using directive or collaborative approaches. Sound therapies include strategies that use background sounds to totally or partially mask tinnitus to reduce the prominence of or decrease the loudness or annoyance of the tinnitus. Purpose We evaluated the effectiveness of tinnitus activities treatment (TAT) in two groups, those without hearing aids (HA) and those who were provided with HA. In both groups, comparisons were made among those receiving (1) counseling only, (2) counseling and partial masking, and (3) counseling and total masking. Research Design Participants were provided with HA or not, based on their choice, and then randomly assigned to one of the three groups. The Tinnitus Handicap Questionnaire (THQ) was used as the primary measure. Results For those without HA, significant benefits were obtained for 8 out of 22 participants in the counseling group, 8 of 13 in the total masking group, and 8 of 24 in the partial mask group. The average decrease in the THQ was 15% for the counseling group, 25% for the total mask, and 14% for the partial masking group. For those with HA; significant benefits were obtained for 5 of 16 in the counseling group, 3 of 14 in the total mask group, and 6 of 13 in the partial mask group. The average decrease in the THQ score was 12% for counseling, 13% for total masking, and 16% for partial masking. No significant differences among groups were observed. Conclusion Individual differences were large. Many benefited from their treatment, but some did not. We believe this was likely influenced by their expectations.

Providing counseling through home pharmacy care (HPC) for hemodialysis patients with hypertension in lowering blood pressure

Objectives Hypertension is one of the main factors in increasing the risk of cardiovascular disease with 51% reported cause of death in chronic kidney disease (CKD) patients with end-stage renal disease (ESRD). It is a comorbid that needs to be managed properly and gets special attention from various health disciplines including a pharmacist. Methods This was a quasi experimental study with pretest–posttest intervention using home pharmacy care (HPC) counseling both on the counseling and the noncounseling group. Initial data collection and informed consent was done at the Hemodialysis Unit Aloei Saboe and Toto Kabila Hospital, Gorontalo. The parameters in the study were patients’ compliance to their medication using the Medication Adherence Questionnaire (MAQ) and Pill Count Adherence (PCA) questionnaires and the patient’s blood pressure. Results Fifty-eight patients met the inclusion criteria and were divided into two groups (the counseling group and the noncounseling group). Based on MAQ and PCA, the level of patient medication adherence increased significantly in the counseling group compared to the noncounseling group with a significance value of p<0.05. Increasing adherence was correlated with patients’ outcome of lowering blood pressure. More patients in the counseling group showed decrease in systolic and diastolic blood pressure compared to the noncounseling group (86.2 vs. 17.2% for systolic BP and 69 vs. 10.3% for diastolic blood pressure (BP). Following adjusted confounding variables, counseling through HPC provided a chance of decreasing systolic blood pressure 32 times (95% CI: 7.198–144.550) and diastolic blood pressure 42 times (95% CI: 6.204–286.677). Conclusions HPC affects the improvement of patient medication adherence and reduction of blood pressure in hemodialysis patients with hypertension.

Konseling Kelompok Berbasis Client Centered Untuk Menurunkan Kecemasan Pada Lansia

ABSTRAK Orang lanjut usia (lansia) memiliki kemungkinan lebih tinggi untuk mengalami gangguan kecemasan daripada depresi. Pengabdian kepada masyarakat ini bertujuan untuk menguji pengaruh konseling kelompok berbasis client-centered untuk menurunkan kecemasan pada lansia. Penelitian ini menggunakan pendekatan kuantitatif tipe eksperimen. Subjek penelitian ini berjumlah 6 wanita lansia dengan rentang usia 62-79 tahun di RW 03 wilayah kerja Puskesmas X. Hasil analisis data menggunakan SPSS menunjukkan koefisien Z = -2,20 dan p = 0,116 ( p < 0,05) artinya ada penurunan kecemasan antara sebelum dan sesduah pemberian konseling kelompok berbasis Client-Centered (rerata skor pretes = 16 dan rerata postes = 10). Dapat disimpulkan bahwa konseling kelompok berbasis Client-Centered dapat menurunkan kecemasan pada lansia. Kata kunci: lansia; cemas; Client Centered. ABSTRACT The elderly have a high probability of anxiety disorder than depression. The type of this research was a quantitative approach with quasi-experiment. The subjects of this study were 6 elderly females in the age range of 62-79 years old who lived at RW 03 near the working area of Puskesmas X. The data analysis shows that the coefficient of Z = -220 and p=0,116 (p < 0,05) mean there was a reduction of the anxiety between the beginning and after giving the counseling group with the Client-Centered method (the average of pretest score= 16 and the average of posttest score=10). The conclusion of this research shows that counseling groups with the Client-Centered method could reduce the anxiety disorder of the elderly. Keywords: elderly; anxiety; Client-Centered

Comparing the Effectiveness of a Wearable Activity Tracker in Addition to Counseling and Counseling Only to Reinforce Leisure-Time Physical Activity among Breast Cancer Patients: A Randomized Controlled Trial

This randomized controlled trial aimed to compare the effectiveness of a wearable activity tracker (WAT) in addition to counseling (WAT+counseling) and counseling only for reinforcing leisure-time physical activity (LTPA) among breast cancer patients during radiotherapy (RT). A total of 152 breast cancer patients who were planning to undergo radiation therapy (RT) after surgery participated in the study. The WAT+counseling group (n = 76) underwent physical activity (PA) self-monitoring using a WAT and participated in counseling. The counseling-only group (n = 76) received telephone counseling once a week during RT and did not receive WAT. The WAT+counseling group had increased relative change in self-reported LTPA (102.8) compared with the counseling-only group (57.8) immediately after RT compared to baseline. Although the relative changes of self-reported LTPA of the WAT+counseling group were higher at three and six months after the end of RT compared to in the counseling-only group, the results were not significant. The mean average daily step count of the WAT+counseling group was 9351.7, which increased to 11,592.2 during RT and 12,240.1 after RT. In the subgroup analysis, patients who did not perform regular PA before cancer diagnosis had significantly increased step counts. This study shows the feasibility of WAT with counseling to reinforce PA among breast cancer patients.