Many women use pharmacological or non-pharmacological pain relief during childbirth. Evidence from Cochrane reviews shows that effective pain relief is not always associated with high maternal ...satisfaction scores. However, understanding women's views is important for good quality maternity care provision. We undertook a qualitative evidence synthesis of women's views and experiences of pharmacological (epidural, opioid analgesia) and non-pharmacological (relaxation, massage techniques) pain relief options, to understand what affects women's decisions and choices and to inform guidelines, policy, and practice.
We searched seven electronic databases (MEDLINE, CINAHL, PsycINFO, AMED, EMBASE, Global Index Medicus, AJOL), tracked citations and checked references. We used thematic and meta-ethnographic techniques for analysis purposes, and GRADE-CERQual tool to assess confidence in review findings. We developed review findings for each method. We then re-analysed the review findings thematically to highlight similarities and differences in women's accounts of different pain relief methods.
From 11,782 hits, we screened full 58 papers. Twenty-four studies provided findings for the synthesis: epidural (n = 12), opioids (n = 3), relaxation (n = 8) and massage (n = 4) - all conducted in upper-middle and high-income countries (HMICs). Re-analysis of the review findings produced five key themes. 'Desires for pain relief' illuminates different reasons for using pharmacological or non-pharmacological pain relief. 'Impact on pain' describes varying levels of effectiveness of the methods used. 'Influence and experience of support' highlights women's positive or negative experiences of support from professionals and/or birth companions. 'Influence on focus and capabilities' illustrates that all pain relief methods can facilitate maternal control, but some found non-pharmacological techniques less effective than anticipated, and others reported complications associated with medication use. Finally, 'impact on wellbeing and health' reports that whilst some women were satisfied with their pain relief method, medication was associated with negative self-reprisals, whereas women taught relaxation techniques often continued to use these methods with beneficial outcomes.
Women report mixed experiences of different pain relief methods. Pharmacological methods can reduce pain but have negative side-effects. Non-pharmacological methods may not reduce labour pain but can facilitate bonding with professionals and birth supporters. Women need information on risks and benefits of all available pain relief methods.
Diabetes mellitus (DM) can cause physical and psychological changes for sufferers. Psychological changes include changes in self-concept and depression. Psychological changes can be treated with ...nonpharmacological therapies, one of which is five-finger relaxation technique. The research aimed to reveal the effect of five-finger relaxation technique on depression experienced by type 2 DM patients. The five-finger relaxation technique is one of the generalist relaxation techniques by recalling pleasant experiences. This research is a quasi-experiment. Samples of this research were 34 respondents whom were selected using purposive sampling. The intervention was carried out once a day for 3 consecutive days. In order to measure depression, a valid and reliable questionnaire of Indonesian version of the Beck Depression Inventory (BDI) was employed. Data were analyzed using the Wilcoxon Test and the Mann-Whitney Test. The results showed the was a decrease in depression in the control group (p-value of 0.008) and the intervention group (p-value of 0.000) and there were differences in depression in the control group and the intervention group (p-value of 0.000). It can be concluded that there is an effect of five-finger relaxation technique on depression in type 2 DM patients.
Purpose
This systematic review aims to summarize eHealth studies with mindfulness- and relaxation-based interventions for medical conditions and to determine whether eHealth interventions have ...positive effects on health.
Method
A comprehensive search of five databases was conducted for all available studies from 1990 to 2015. Studies were included if the intervention was mainly technology delivered and included a mindfulness- or relaxation-based intervention strategy and if patients with a medical condition were treated. Treatment effects were summarized for different outcomes.
Results
A total of 2383 records were identified, of which 17 studies with 1855 patients were included in this systematic review. These studies were conducted in patients with irritable bowel syndrome, chronic fatigue syndrome, cancer, chronic pain, surgery, and hypertension. All but one study were delivered online through a web-based platform; one study delivered the intervention with iPods. The studies indicate that mindfulness- and relaxation-based eHealth interventions can have positive effects on patients’ general health and psychological well-being. No effects were found for stress or mindfulness. Only five studies reported economic analyses of eHealth interventions without any clear conclusion.
Conclusion
There is some evidence that mindfulness- and relaxation-based eHealth interventions for medical conditions can have positive effects on health outcomes. Therefore, such interventions might be a useful addition to standard medical care. No app studies were retrieved, even though a vast number of smartphone apps exist which aim at increasing users’ health. Therefore, more studies investigating those health apps are needed.
Alptraumbehandlung bei Kindern und Jugendlichen Pietrowsky, Reinhard; Thünker, Johanna
Somnologie : Schlafforschung und Schlafmedizin = Somnology : sleep research and sleep medicine,
09/2023, Volume:
27, Issue:
3
Journal Article
Peer reviewed
Zusammenfassung
Alpträume sind bei Kindern und Jugendlichen häufig, aber selten untersucht. Obwohl die meisten Alpträume in dieser Altersgruppe keiner Behandlung bedürfen, ist das der Fall, wenn sie ...sehr lange andauern oder deutliche Beeinträchtigungen und Leiden verursachen. Der Artikel gibt eine Übersicht über Behandlungsmethoden von Alpträumen bei Kindern und Jugendlichen und deren Evidenzstand. Alpträume können mithilfe der Imagery-Rehearsal-Therapie (IRT) erfolgreich behandelt werden. Wie bei Erwachsenen beinhaltet die IRT bei Kindern und Jugendlichen die Rekapitulation eines Alptraums, seine Modifikation in einen nicht bedrohlichen Traumverlauf und die wiederholte Imagination dieses modifizierten Traums. Für Kinder und Jugendliche sollte die Modifikation des Alptraums mit altersgerechten Mitteln erfolgen, wie etwa den Traum malen, basteln, ihn mit Handpuppen oder Rollenspielen darstellen oder in einem Song ausdrücken. Eine manualisierte Version der IRT für Kinder und Jugendliche wird kurz dargestellt.
Abstract Background Chronic neuropathic pain is often associated with conditions such as depression and anxiety and strongly affects daily functioning and overall quality of life. It is argued, ...therefore, that psychosocial interventions should be added to traditional biomedical interventions. This systematic review evaluates the effectiveness of cognitive and behavioral interventions for the management of chronic neuropathic pain. Methods Electronic databases were searched for all types of studies. Studies were selected by predefined inclusion criteria. Methodological quality was assessed with the Health Technology Assessment-Disease Management instrument. Furthermore, an explorative meta-analysis of four selected studies was performed. Results Fourteen studies were assessed: three randomized controlled trials, three controlled before–after studies, seven uncontrolled before–after studies and one time series analysis. The findings of the meta-analysis were not consistent with a significant effect on pain intensity. Only one study had good methodological quality; it showed some significant effects of the interventions, but only in female participants. Other studies of limited methodological quality did report positive effects on pain and quality of life. Conclusions This is the first systematic review that has evaluated the effectiveness of cognitive and behavioral techniques for the management of chronic neuropathic pain. Given the limited methodological quality, no informative conclusions can be drawn with respect to the study objective. However, this review does provide insight into the difficulties of this specific area, the need for a clear and widely accepted definition of neuropathic pain and the need for standardized multidimensional measurement instruments.
To evaluate the effects of Myofascial Release Technique (MRT) with a roller massager combined with core stabilization exercises (CSE) in elderly with non-specific low back pain (NSLBP).
A total of ...forty-five participants were randomly divided into two groups (CSE and CSE+MRT). A core stabilization exercise program was applied for the participants in the CSE group for 3 days per week for a total of 6 weeks. In addition to the core stabilization exercises, myofascial relaxation technique with a roller massager was performed for 3 days per week for 6 weeks for the participants in the CSE+MRT group. Participants were assessed in terms of pain, low back disability, lower body flexibility, kinesiophobia, core stability endurance, spinal mobility, gait characteristics and quality of life both pre- and post-treatment.
It was found that the improvement in core stability endurance (p=0.031) and spinal mobility (in the sagittal plane) (p=0.022) was greater in the CSE+MRT group compared to the CSE group. There was no significant difference between the two groups in terms of pain, low back disability, lower body flexibility, kinesiophobia, gait characteristics and quality of life (p>0.05).
The current study suggests that myofascial release technique with a roller massager combined with core stabilization exercises can be a better choice in the treatment of NSLBP in elderly.
NCT03898089.
Floatation-REST (Reduced Environmental Stimulation Therapy) reduces sensory input to the nervous system through the act of floating supine in a pool of water saturated with Epsom salt. The float ...experience is calibrated so that sensory signals from visual, auditory, olfactory, gustatory, thermal, tactile, vestibular, gravitational and proprioceptive channels are minimized, as is most movement and speech. This open-label study aimed to examine whether Floatation-REST would attenuate symptoms of anxiety, stress, and depression in a clinical sample. Fifty participants were recruited across a spectrum of anxiety and stress-related disorders (posttraumatic stress, generalized anxiety, panic, agoraphobia, and social anxiety), most (n = 46) with comorbid unipolar depression. Measures of self-reported affect were collected immediately before and after a 1-hour float session, with the primary outcome measure being the pre- to post-float change score on the Spielberger State Anxiety Inventory. Irrespective of diagnosis, Floatation-REST substantially reduced state anxiety (estimated Cohen's d > 2). Moreover, participants reported significant reductions in stress, muscle tension, pain, depression and negative affect, accompanied by a significant improvement in mood characterized by increases in serenity, relaxation, happiness and overall well-being (p < .0001 for all variables). In reference to a group of 30 non-anxious participants, the effects were found to be more robust in the anxious sample and approaching non-anxious levels during the post-float period. Further analysis revealed that the most severely anxious participants reported the largest effects. Overall, the procedure was well-tolerated, with no major safety concerns stemming from this single session. The findings from this initial study need to be replicated in larger controlled trials, but suggest that Floatation-REST may be a promising technique for transiently reducing the suffering in those with anxiety and depression.
ClinicalTrials.gov NCT03051074.
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