Improvements In Emotional Health Research Articles

Shared medical appointments and quality of life for children with HIV-AIDS

Background The human immunodeficiency virus (HIV) infects immune cells and weakens the immune system. There are 36.9 million HIV sufferers worldwide, with 1.8 million of them being children. Children with HIV and their parents may benefit from focus group discussions, also known as shared medical appointments (SMAs). SMAs represent an educational method capable of enhancing the quality of healthcare services. However, this method remains relatively under-researched in HIV/AIDS patients.
 Objective To assess the impact of SMA on the quality of life of children with HIV-AIDS.
 Methods This quasi-experimental study with a cross-sectional approach was carried out for 2 months. Subjects participated in SMAs, accompanied by a pediatrician as facilitator. Subjects filled three Pediatric Quality of Life (PedsQL) questionnaires (Inventory 4.0, General Well-Being Scale 3.0, and Healthcare Satisfaction 3.0), before and after attending SMAs. We compared the results.
 Results There were 12 respondents, with the majority aged 5-10 years (50%), and a higher proportion of male than female (33.3%). The majority of boys had stage 3 HIV, while most girls had stage 2 HIV. According to the PedsQL Inventory module, the average quality of life for the physical aspect was the highest (83), while the lowest was observed in the school aspect (45). In the General Well-being module, the average emotional health scores were 84 before and 93 after SMAs, which were higher than the overall health scores (68 and 77 before and after SMAs, respectively). In the Healthcare Satisfaction module, the lowest average scores were in family satisfaction (52 before and 64 after SMAs), whereas the highest were in satisfaction with healthcare provider treatment (87 and 81 before and after SMAs, respectively). There was a significant increase before and after the SMAs in emotional health (P=0.009).
 Conclusion An improvement in emotional health was observed based on the General Well-being module of the PedsQL before and after SMAs intervention. Thus, SMAs may potentially improve the quality of life for children with HIV-AIDS.

Neuromuscular Training, Exercise Physiology Clinic, Real-time Exercise, and Cardiac Rehabilitation

Neuromuscular Training, Exercise Physiology Clinic, Real-time Exercise, and Cardiac Rehabilitation

Association of glucocorticoid doses and emotional health in lupus low disease activity state (LLDAS): a cross-sectional study

BackgroundWhile survival of systemic lupus erythematosus (SLE) patients has improved substantially, problems remain in the management of their emotional health. Medium to high-dose glucocorticoid doses are known to worsen emotional health; the effect is unclear among patients receiving relatively low-dose glucocorticoids. This study aims to investigate the association between low glucocorticoid doses and emotional health in lupus low disease activity state (LLDAS).MethodsThis cross-sectional study drew on data from SLE patients in 10 Japanese institutions. The participants were adult patients with SLE duration of ≥ 1 year who met LLDAS criteria at the study visit from April 2018 through September 2019. The exposure was the daily glucocorticoid dose (mg oral prednisolone). The outcome was the emotional health score of the lupus patient-reported outcome scale (range: 0 to 100). Multiple linear regression analysis was performed with adjustment for confounders including disease-related damage, activity, and psychotropic drug use.ResultsOf 192 patients enrolled, 175 were included in the analysis. Their characteristics were as follows: female, 89.7%; median age, 47 years (interquartile range (IQR): 37.0, 61.0). Median glucocorticoid dose was 4.0 mg (IQR 2.0, 5.0), and median emotional health score 79.2 (IQR 58.3, 91.7). Multiple linear regression analysis showed daily glucocorticoid doses to be associated with worse emotional health (β coefficient = − 2.54 [95% confidence interval − 4.48 to − 0.60], P = 0.01).ConclusionsDaily glucocorticoid doses were inversely associated with emotional health among SLE patients in LLDAS. Further studies are needed to determine whether glucocorticoid tapering leads to clinically significant improvements in emotional health.

Amelioration of motor and nonmotor symptoms in cortical cerebellar atrophy and multiple system atrophy-cerebellar type by inpatient rehabilitation: a retrospective study.

Sporadic spinocerebellar degenerative diseases such as multiple system atrophy (cerebellar type) and cortical cerebellar atrophy typically present with cerebellar ataxia. Multiple system atrophy is characterized by ataxia, with parkinsonism, dysautonomia and neuropsychiatric symptoms, resulting in reduced quality of life. Effects of physical rehabilitation focused on motor symptoms with ataxia in nonmultiple system atrophy patients have been reported; however, without addressing concomitant nonmotor symptoms. Here, we examined the motor, nonmotor and quality of life effects of inpatient physical rehabilitation in 15 multiple systems atrophy and nine cortical cerebellar atrophy patients without dementia. Rehabilitation involved a 4-week hospitalization with physical, occupational and speech therapy. The following assessments were conducted at admission and discharge: the scale for the assessment and rating of ataxia for ataxia; Montreal cognitive assessment for cognition, hospital anxiety and depression scale for emotion and medical outcomes study short-form for health-related quality of life. Data were analyzed for statistical significance (P < 0.05) using the Wilcoxon signed-rank test. In patients with multiple system atrophy, rehabilitation significantly improved ataxia, cognition with mild cognitive impairment (73.3%) and health-related quality of life; however, patients with depression (86.7%) showed no improvement in emotional health and quality of life. Similar effects on motor and nonmotor symptoms were observed in patients with cortical cerebellar atrophy. This suggests that inpatient rehabilitation could not only improve motor and nonmotor functions, but also the quality of life in patients with spinocerebellar degenerative disease.

Social participation following a stroke: an assessment in accordance with the international classification of functioning, disability and health

Objective: Evaluate, code and qualify the participation of Brazilian stroke survivors based on the international classification of functioning, disability and health (ICF) and identify predictors of post-stroke participation.Methods: An exploratory, observational, cross-sectional study was conducted involving 78 individuals with hemiparesis stemming from a stroke. The stroke specific quality of life (SS-QOL) was used to evaluate the participation component of the ICF. The geriatric depression scale was used to screen depressive symptoms; the functional independence measure (FIM) was used to measure the degree of dependence; grip strength was determined using a dynamometer; and cognitive status was evaluated using the mini mental state examination. The one-way analysis of variance followed by the Bonferroni test was used for the comparison the participation scores of different groups (age and marital status). The independent t-test was used for the comparisons of the other groups (sex, time since the occurrence of stroke (<12 months or >12 months) and degree of functional independence). Multiple linear regression was employed to identify measures capable of predicting participation.Results: Based on the classification and qualifiers of the ICF, the individuals analyzed exhibited a moderate level of participation. Participation was significantly associated with time since the occurrence of stroke (F = 2.46; 95% confidence interval (CI) = −23.67–0.34; p = 0.05), degree of functional independence (F = 2.40; 95% CI = −33.0 to −18.93; p < 0.001) and marital status (married or widowed) (F = 2.6; p = 0.05). No statistically significant associations were found with regard to age, sex or affected side of the body. Functional independence was the main predictor of participation (F = 99.2; r2 = 0.57; p <0.001) and the occurrence of depressive symptoms was a moderate predictor (F =12.78; r2 = 0.40; p = 0.001).Conclusions: Twenty-four ICF categories were coded and qualified with the use of the SS-QOL, enabling the participation component of the ICF biopsychosocial model to be easily evaluated in clinical practice. Overall, the sample in the present study demonstrated a moderate decline in participation following a stroke and only the “social roles” domain was severely affected. The FIM was the main predictor of participation and the depression was a moderate predictor. Therefore, health professionals involved in the rehabilitation of these patients should focus on the promotion of functional independence and improvements in emotional health to optimize social participation following a stroke.Implications for RehabilitationThe Brazilian stroke individuals analyzed exhibited a moderate level of participation.Functional independence was the main predictor of participation and the occurrence of depressive symptoms was a moderate predictor. Age, sex and affected side of the body were not predictors of participation.Our findings support that twenty-four International classification of functioning, disability and health categories were coded and qualified with the use of the stroke specific quality of life.Rehabilitation of social functioning post stroke patients should be focused on the promotion of functional independence and improvement in emotional health.This study offers a participation assessment model that can facilitate the incorporation of the ICF in the clinical practice.

MINDFULNESS FOR EARLY ALZHEIMER’S DISEASE: A PILOT STUDY

Studies have demonstrated that mindfulness training reduces stress and depression among Alzheimer's caregivers, but little evidence exists regarding the feasibility and impact of a mindfulness program for people with early Alzheimer's. The Mindfulness Pilot Study compared a mindfulness program designed for people with early Alzheimer's disease and their care partners (dyads) to the Memory Club, a psycho-educational support intervention for this population. The study was conducted in 2 phases over 4 months. In phase 1, dyads were recruited for the Mindfulness program. In phase 2, additional dyads were recruited for the Memory Club. Both interventions included two-hour sessions once weekly for 10 weeks with additional sessions for pre and post outcome measurement. Outcomes related to mood, emotional and physical health, wellbeing, stress, anxiety, and self-compassion were evaluated. Change scores were calculated for all outcomes measures. Mindfulness and Memory Club interventions were analyzed using paired t-tests or mixed effect models. Thirty-eight participants enrolled in the Mindfulness (10 dyads) and Memory Club (9 dyads) programs. The majority of participants rated the interventions as easy to learn, likely to incorporate in their lifestyles, valuable and facilitated effectively. The Mindfulness intervention resulted in significant pre-post improvements in emotional health and depression for participants with Alzheimer's (p=.018), while Memory Club participants with Alzheimer's reported significant increases in stress and reduced serenity (p=.003). When comparing the groups to each other, participants with Alzheimer's in the Mindfulness group had significantly reduced anxiety, depression and stress, improved emotional health and increased serenity, while the caregivers had significantly reduced depression, burden and higher self-compassion over participants in the Memory Club. Results support the feasibility and efficacy of a Mindfulness program for people living with early Alzheimer's. Interventions that provide disease education may temporarily increase anxiety and depression among participants. Mindfulness interventions offer participants stress reduction strategies that may help to counteract this effect and offer long-term coping strategies for families living with Alzheimer's.

The Effect of Changes in Health Beliefs Among African-American and Rural White Church Congregants Enrolled in an Obesity Intervention: A Qualitative Evaluation.

Church interventions can reduce obesity disparities by empowering participants with knowledge and skills within an established community. The purpose of this study was to evaluate the Biomedical/Obesity Reduction Trial (BMORe) and investigate changes in health beliefs among obese adult participants. Ten pre-/post-intervention focus groups applying the Health Belief Model conducted in two African-American churches in Tennessee (n=20) and South Carolina (n=20), and one rural Appalachian church in Kentucky (n=21). Two independent coders using NVivo analyzed transcribed audio data and notes. Participants' health status of being overweight/obese and having comorbidities of diabetes and high blood pressure motivated enrollment in BMORe. Initially participants voiced low self-efficacy in cooking healthy and reading food labels. BMORe made participants feel "empowered" after 12weeks compared to initially feeling "out of control" with their weight. Participants reported improvements in emotional health, quality of life, and fewer medications. During post-intervention focus groups, participants reported increased self-efficacy through family support, sharing healthy eating strategies, and having accountability partners. Solidarity and common understanding among BMORe participants led focus group attendees to comment how their peers motivated them to stay in the program for 12weeks. Long-term barriers include keeping the weight off by maintaining habits of exercise and healthy eating. Implementation of pre-/post-intervention focus groups is an innovative approach to evaluate an obesity intervention and track how changes in health beliefs facilitated behavior change. This novel approach shows promise for behavioral interventions that rely on participant engagement for sustained effectiveness.

Post-Placement Adjustment and the Needs of Birthmothers Who Place an Infant for Adoption

This study examines the emotional health of women who placed an infant for adoption during the first year post-placement and in their current life. Data were collected from 235 women, on average, 3.5 years after placement. Approximately 75% of women viewed their emotional health as “very poor,” “poor,” or “neutral” in the first year post-placement. Despite improvement in emotional health over time, over a third continued to report significant problems in their current life. Birthmothers' adjustment was positively related to level of support and to support satisfaction. Implications for helping women recover from this life stressor are discussed.

Feasibility of a Mindfulness-Based Intervention for Aboriginal Adults with Type 2 Diabetes

Type 2 diabetes mellitus (T2DM) is recognized as a worldwide epidemic and the health concern is particularly problematic among indigenous populations. Canada’s Aboriginal population experiences rates of T2DM that are 2.5–5.3 times higher than the non-Aboriginal population. Stress is understood to play a role in both the development and maintenance of diabetes, which makes stress reduction an avenue for health improvement in these patients. Stress is known to be an integral part of life for commonly disadvantaged Aboriginal people and we hypothesized that, due to its known stress reduction effects, a mindfulness intervention could lead to health improvements for those with T2DM. We also thought that the mind/body approach of a mindfulness intervention would be appropriate for, and acceptable to, Aboriginal people whose healing traditions incorporate aspects of mind, body, and spirit. To test the feasibility of such an approach, we recruited Aboriginal participants from urban and rural centres in Manitoba, Canada who took part in an 8-week, modified mindfulness intervention. Following the program, participants (N = 11) experienced significant and clinically important reductions in blood sugar (HbA1c reduced by .43 %, p = .02; d = .37) and blood pressure (mean arterial pressure reduced by 7.91 mm Hg, p = .05; d = .85). They also reported significant improvements in emotional health. Our small sample limits the generalizability of our findings but our results provide preliminary evidence of feasibility, which supports further exploration of the efficacy and effectiveness of mindfulness-based interventions for indigenous people with T2DM.

Physiological and Psychological Response to Floral Scent

To better understand how fragrance may enhance human health, this study examined psychophysiological responses to Japanese plum blossom fragrance. Although previous studies used essential oils or fragrance components, the present study measured the effects of floral scent naturally diffused by the plant itself to simulate the way we generally experience natural scent in everyday life. Subjects were Japanese males (n = 26), and the data collected included cerebral and autonomic nervous system activities, semantic differential (SD) scale, and profile of mood states (POMS). Exposure to the fragrance significantly activated the sympathetic nervous system and the cerebral areas related to movement, speech, and memory. SD scale and POMS results showed the fragrance evoked cheerful, exciting, and active images and changed mood states by enhancing vigor while suppressing feelings of depression. These findings indicate that contact with a floral scent such as plum blossom fragrance can improve mood states and may foster the brain functions of memory, speech, and movement, potentially leading to improvements in emotional health, depression, and memory disorders.

The FRIENDS emotional health prevention programme

A universal cognitive behaviour therapy emotional health programme, FRIENDS, was provided in schools by trained school nurses to 106 children aged 9/10. Anxiety and self-esteem were re-assessed in 63 children one year after completing the programme. The significant improvements in emotional health identified 3 months after FRIENDS were maintained 12 month after completing the programme. Of the 9 children identified at baseline as high risk, 6 (67%) had moved into the low risk category by the 12 month follow-up. Of the low risk children, none had become high risk by follow-up. The study conclusions are limited by a small sample size and the absence of a comparison group. They are however consistent with previous studies and suggest that FRIENDS delivered in schools as a universal intervention can have a significant medium term effect upon emotional health.

Impact of a Workplace Stress Reduction Program on Blood Pressure and Emotional Health in Hypertensive Employees

This study examined the impact of a workplace-based stress management program on blood pressure (BP), emotional health, and workplace-related measures in hypertensive employees of a global information technology company. Thirty-eight (38) employees with hypertension were randomly assigned to a treatment group that received the stress-reduction intervention or a waiting control group that received no intervention during the study period. The treatment group participated in a 16-hour program, which included instruction in positive emotion refocusing and emotional restructuring techniques intended to reduce sympathetic nervous system arousal, stress, and negative affect, increase positive affect, and improve performance. Learning and practice of the techniques was enhanced by heart rate variability feedback, which helped participants learn to self-generate physiological coherence, a beneficial physiologic mode associated with increased heart rhythm coherence, physiologic entrainment, parasympathetic activity, and vascular resonance. BP, emotional health, and workplace-related measures were assessed before and 3 months after the program. Three months post-intervention, the treatment group exhibited a mean adjusted reduction of 10.6 mm Hg in systolic BP and of 6.3 mm Hg in diastolic BP. The reduction in systolic BP was significant in relation to the control group. The treatment group also demonstrated improvements in emotional health, including significant reductions in stress symptoms, depression, and global psychological distress and significant increases in peacefulness and positive outlook. Reduced systolic BP was correlated with reduced stress symptoms. Furthermore, the trained employees demonstrated significant increases in the work-related scales of workplace satisfaction and value of contribution. Results suggest that a brief workplace stress management intervention can produce clinically significant reductions in BP and improve emotional health among hypertensive employees. Implications are that such interventions may produce a healthier and more productive workforce, enhancing performance and reducing losses to the organization resulting from cognitive decline, illness, and premature mortality.

The Emotional Effects of Writing About Stressful Experiences: An Exploration of Moderators

The emotional effects of writing about stressful experiences was studied using a quasi-experimental design in which ninety-one college students, who journaled for fifteen minutes on two occasions, were compared to 71 participants in a comparison group. Locus of control, extroversion, and previous experience with journaling were considered as moderating variables. The results indicated greater improvements in emotional health for the treatment group, with males benefiting to a greater degree than females. These findings suggest the short-term effectiveness of brief journaling interventions across the personality dimensions considered. The relevance of these findings for occupational therapists is considered.