Mindfulness-based Stress Reduction Research Articles

Mechanisms of Mindfulness: A Longitudinal Study of a Mindfulness-Based Stress Reduction Program

Mechanisms of Mindfulness: A Longitudinal Study of a Mindfulness-Based Stress Reduction Program

Exploring unmet needs and preferences of young adult stroke patients for post-stroke care through PROMs and gender differences

BackgroundStroke incidence among young adults of working age (under 65 years of age) has significantly increased in the past decade, with major individual, social, and economic implications. There is a paucity of research exploring the needs of this patient population. This study assessed: (1) young adult stroke patients' physical, psychological, and occupational functioning and health-related quality of life (HRQoL); and (2) post-stroke care preferences using patient-reported outcome measures (PROMs), with attention to gender differences.MethodsA cross-sectional pilot study was conducted. Sociodemographic and clinical characteristics were collected through chart review and data on occupational function, physical, psychological, and social wellbeing >90 days post-stroke through a self-reported survey. Descriptive statistics, gender-based, and regression analyses were conducted.ResultsThe sample included 85 participants. Participants reported impairments in both, occupational functioning, with 58.7% not returned to work (RTW), and HRQoL, specifically with social activities (37%), anxiety (34%), and cognitive function (34%). Women had significantly (p < 0.05) worse physical symptoms (sleep disturbance and fatigue), emotional health (depression, stigma, emotional dyscontrol) scores, and sense of self-identify post-stroke. Over 70% of participants preferred in-person post-stroke care led by health care providers and felt they would have benefited from receiving information on physical health (71.4%), emotional and psychological health (56.0%), RTW (38.1%), and self-identity (26.2%) post-stroke. Women preferred cognitive behavioral therapy (p = 0.018) and mindfulness-based stress reduction therapy (p = 0.016), while men preferred pharmacotherapy (p = 0.02) for psychological symptoms.ConclusionThis is the first study to report impaired HRQoL, psychological and occupational functioning using PROMs, with significant gender differences and preferences for post-stroke care delivery among young adult stroke patients at >90 days after stroke. The findings highlight the importance of needs, gender, and age-specific post-stroke education and interventions.

The effect of conscious mindfulness-based informative approaches on managing symptoms in hemodialysis patients

IntroductionThe research was conducted to determine the effect of conscious mindfulness based informative approaches applied in hemodialysis patients on reducing stress and managing symptoms.MethodsThis research was conducted as a real experimental model with a control group. Research population consisted of 160 hemodialysis patients. The sample of the study was determined as 120 hemodialysis patients in total, 60 in the experimental and 60 in the control group, as a result of the power analysis. After the pre-test application, a mindfulness-based stress reduction program was applied to the experimental group. In the analysis of the data collected in the research, percentage, frequency, chi-square analysis, t-test for independent groups, t-test for dependent groups were used by means of SPSS for Windows 22.00 statistical software package.ResultsThe t-test analyses of the differences between pre-test and post-test scores of hemodialysis patients in the experimental group were found to be significant in favor of the post-tests.DiscussionIt was found out that the conscious mindfulness-based informative approaches decreased the perceived stress and anxiety of the patients in the experimental group, whereas increased their levels of conscious mindfulness and symptom management.

The Selah trial: A preference-based partially randomized waitlist control study of three stress management interventions.

Chronic stress undermines psychological and physiological health. We tested three remotely delivered stress management interventions among clergy, accounting for intervention preferences. United Methodist clergy in North Carolina enrolled in a partially randomized, preference-based waitlist control trial. The interventions were: mindfulness-based stress reduction (MBSR), Daily Examen prayer practice, and Stress Proofing (stress inoculation plus breathing skills). Co-primary outcomes were symptoms of stress (Calgary Symptoms of Stress Inventory) and 48-hour ambulatory heart rate variability (HRV) at 12 weeks compared to waitlist control. Survey data were collected at 0, 12, and 24 weeks and 48-hour ambulatory HRV at 0 and 12 weeks. The 255 participants were 91% White and 48% female. Forty-nine participants (22%) without a preference were randomly assigned between the three interventions (n = 40) and waitlist control (n = 9). Two hundred six participants (78%) with a preference were randomly assigned to waitlist control (n = 62) or their preferred intervention (n = 144). Compared to waitlist control, MBSR [mean difference (MD) = -0.30, 95% CI: -0.41, -0.20; P < .001] and Stress Proofing (MD = -0.27, 95% CI: -0.40, -0.14; P < .001) participants had lower stress symptoms at 12 weeks; Daily Examen participants did not until 24 weeks (MD = -0.24, 95% CI: -0.41, -0.08). MBSR participants demonstrated improvement in HRV at 12 weeks (MD = +3.32ms; 95% CI: 0.21, 6.44; P = .036). MBSR demonstrated robust improvement in self-reported and objective physical correlates of stress; Stress Proofing and Daily Examen resulted in improvements in self-reported correlates of stress. These brief practices were sustainable and beneficial for United Methodist clergy during the heightened stressors of the COVID pandemic. ClinicalTrials.gov identifier: NCT04625777.

A brief mindfulness-based intervention for stress, pain, emotion and attention regulation in military service members with mild traumatic brain injury.

The primary aim of this study was to conduct an open pilot clinical trial of a brief mindfulness-based intervention for persistent postconcussion symptoms that occur after mild traumatic brain injury in military service members. For many service members, operational tempo and other time constraints may prevent them from completing a standard mindfulness-based stress reduction course. Thus, this study sought to examine the effectiveness of a five-session intervention called mindfulness-based stress, pain, emotion, and attention regulation (MSPEAR). Participants were active duty service members with a history of mild traumatic brain injury (TBI) and persisting postconcussion symptoms, all of whom were recruited from an outpatient TBI rehabilitation program at a military treatment facility. Of the 38 service members that were initially enrolled, 25 completed the 5-session MSPEAR intervention, and 20 returned for a 5-week follow-up evaluation. Questionnaires assessing perceived stress, positive affect, pain interference and catastrophizing, sleep disturbances, perceived behavioral and attention regulation, self-efficacy and satisfaction with life were administered at preintervention, postintervention, and at 5-week follow-up intervals. Neuropsychological testing at preintervention and 5-week follow-up included performance validity measures, attention, working memory, and executive function measures. T-tests were run to compare for questionnaire measures at preintervention (Time 1) to postintervention (Time 2). Repeated analysis of variances were conducted to compare questionnaire and neuropsychological measures at Time 1, Time 2, and at Time 3 which is the 5-week follow-up. Improvements in perceived stress, positive affect, behavioral regulation, metacognition, sleep disturbance, self-efficacy, and satisfaction with life were found immediately after the MSPEAR intervention and were maintained at the 5-week follow-up. Magnification and helplessness aspects of pain catastrophizing improved when comparing preintervention to the 5-week follow-up. Pain interference was not significantly different across study assessment times. Neuropsychological testing revealed improvements in sustained attention, working memory, cognitive flexibility, and inhibitory control when comparing preintervention to the 5-week follow-up assessment. The MSPEAR intervention appears to show promise as a brief and effective therapy for specific postconcussion symptoms after mild traumatic brain injury in military service members. Each of the components of MSPEAR including stress, pain catastrophizing, emotion and attention regulation showed improvements in this study, and bears further investigation in a larger scale, preferably randomized controlled trial in those active duty military service members who experience persisting symptoms after a mild traumatic brain injury.

Abstract PO5-11-09: Participants’ experience with an online mindfulness-based stress reduction intervention for anxiety management in breast cancer survivors: A secondary analysis of a randomized trial

Abstract Background Breast cancer (BC) diagnosis and treatment can lead to multiple symptoms with a negative impact on the quality of life of survivors. Mindfulness-based stress reduction (MBSR) interventions have shown to improve anxiety, depression, and stress in patients with cancer across multiple settings. However, the effectiveness of an online MBSR program has not been studied. Methods This is an explanatory qualitative sub-study of a randomized trial of an online MBSR intervention versus a waitlist control. Participants were Mexican women aged ≥18 years diagnosed with stage 0-III BC 1-5 years prior to inclusion, not currently undergoing chemotherapy or radiotherapy, with moderate to severe anxiety (baseline GAD-7 score ≥10). The intervention consisted of 8 weekly 2-hour Zoom sessions with body scan meditation and yoga practice led by a certified instructor. Participants received a digital manual with exercises, audio for guided practice, and a video of postures for balance and flexibility. The primary outcome of the trial was anxiety at 2, 5, and 8 months after the intervention. Two focus groups were conducted via Zoom; 21 participants from the intervention arm were selected and invited according to the difference in GAD-7 scores between baseline and 8 months. The first group consisted of 7 participants (median age 53 years, range 39-62) with a decrease in GAD-7 score of ≥4 points (mean -9.1, SD 3.7); the second group consisted of 7 participants (median age 54 years, range 44-64) with a decrease of &amp;lt; 4 points or an increase in GAD-7 score (mean -1.2, SD 1.9). Each focus group was conducted 14 and 9 months after the MBSR intervention, respectively, and had a duration of 110 and 113 minutes, respectively. Audio and video were recorded and transcribed verbatim. Transcripts were analyzed and themes were developed, focusing on participants’ experience with the online intervention and its perceived benefits. Results The weekly sessions and at-home practice functioned as a “personal haven” for participants. At-home deliberate practice and the additional audio and video materials were considered essential for the effectiveness of the intervention. Participants no longer needed to consciously follow step-by-step directions, as the practices had become a part of who they were, even several months after the intervention. Breathing exercises were frequently used by participants on a day- to-day basis. Regarding the mindfulness practice itself, some participants indicated that they noticed positive changes in their character and demeanor, and in their reactions to everyday and BC-related stressors, including situations such as medical consultations and possible news regarding their treatment. In that sense, they mentioned that all they learned is useful for their life in general, and not exclusive to BC survivors. Despite differences in improvement of anxiety by GAD-7 scores between the focus groups, most participants in both groups referred to the intervention as “life-changing”. Most participants in both groups perceived the online format of the intervention as positive: it allowed them to join in from any location and fit the program into their daily routine with less time commitment. Likewise, the privacy of their homes made them feel more comfortable expressing themselves during the weekly sessions. A high level of recognition, appreciation and gratitude towards the instructor was observed. Some participants noted that contact with the instructor and other participants was limited due to the online format, preventing them from forming friendships or a sense of community. Conclusion BC survivors’ opinion of an online MBSR program was largely positive regarding the benefits of the intervention and its delivery format. Moreover, the intervention was successful at facilitating participants’ adoption of mindfulness practice in their daily lives and at improving other aspects of their lives beyond BC. Citation Format: Haydee Cristina Verduzco-Aguirre, Maura Pompa Mansilla, Misael Salazar-Alejo, Javier Gutierrez Ornelas, Fernanda Mesa-Chavez, Ana Ferrigno Guajardo, Cynthia Villarreal-Garza. Participants’ experience with an online mindfulness-based stress reduction intervention for anxiety management in breast cancer survivors: A secondary analysis of a randomized trial [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-11-09.

Abstract PO1-10-10: Leveraging technology to optimize symptom management and patient empowerment in routine breast cancer care: implementation of a remote patient monitoring (RPM) pathway across 24 hospitals in Europe

Abstract Background: In clinical trials, RPM has been proven to improve the quality of life and toxicity management for patients receiving systemic treatment and is recommended by international guidelines for routine clinical practice (Di Maio et al., Ann Oncol 2022). Resilience is an oncology-specific RPM system (CE marked, class IIa medical device - mobile application [app] or web interface) which prompts patients to complete a weekly survey including core symptoms from NCI’s PRO-CTCAE questionnaire. Severe or worsening symptoms trigger an alert notification sent to the patient’s care team. In addition to the RPM system, the mobile app offers a large pool of breast cancer-specific educational, self-management, and patient empowerment resources that are personalized according to symptoms reported, disease stage, and treatments received. Here we present the implementation of the Resilience RPM pathway in routine breast cancer care across 24 highly diverse cancer centers. Methods: The implementation process followed a phasic process of Exploration, Preparation, Implementation, and Sustainability that involved close collaboration with technology providers, hospital managers, and care teams at participating cancer centers to coordinate, train, provide technical assistance, and respond to site-specific needs. In addition, monthly webinars offered participating centers an opportunity to share best practices and ways to overcome implementation barriers. A dedicated platform with educational RPM resources for healthcare providers was also available. A process evaluation according to the RE-AIM framework was performed assessing the reach, adoption, implementation, and maintenance of the RPM pathway in routine care. The effectiveness of the pathway was assessed as the ability of the care team to timely respond to alerts. Aggregated system level metric of RPM was collected covering patients with breast cancer under active systemic treatment followed by Resilience from 01-11-2021 to 29-06-2023. Usage data of mobile app resources was tracked from 01-01-2023 to 29-06-2023. Qualitative assessments with focus groups complemented this evaluation. Results: 985 patients, 1% male, 99% female, with a median age of 57y (range: 21-95y; P25-75 38.5-64.5y), were registered across 24 cancer centers. In the last 6 months, the predominant RPM interface chosen by patients was the mobile app (64.1 vs 35.9% for the web platform). Adherence to weekly ePRO reporting was 89.4% in the mobile app and 86.6% in the web platform. The median time from prompt receipt to survey completion was 5.6 hours. The median time for the nurse navigator (NN) to process an alert was 3h50min. Most alerts (91%) were handled directly by NN with 9% requiring the support of a physician. The mean number of individual content consumed per patient was 13 (6744 resources/523 pts, 100% of app users accessed resources). Preferred formats of content delivery were written articles (66.5%), followed by videos (23.1%) and podcasts (10.4%). Most assessed contents referred to: symptom management advice (16%), followed by information about breast cancer disease characteristics (12.5%), supportive care strategies (11.5%), self-guided exercises of mindfulness-based stress reduction (9.4%), and breast cancer treatment journey (8.3%). Qualitative assessments of the app interface, educational content, and self-management programs revealed high levels of satisfaction. The RPM pathway is sustained in the 24 cancer centers and implementation is expanding to additional centers. Conclusion: The Resilience RPM pathway was successfully implemented in routine care across a diverse group of cancer centers with elevated levels of patient engagement and responsiveness from NN. In addition, patients accessed evidence-based educational and empowerment resources, adapted to their medical profile according to their preferences and learning style. Citation Format: Maria Alice Franzoi, Arlindo R Ferreira, Juliette Fanton d'Andon, Thomas Grellety, Eliane Ithurbide-Dachary, Laura Polastro, Laurence Caravella, Joseph Rodriguez, Nathanaelle Leprevier, Elsa Blanchard, Stéphane Remy, Belen d' Ythurbide, Romain Rivoirard, Raoudha Boughzala, Joana M Ribeiro, Ines Vaz Luis. Leveraging technology to optimize symptom management and patient empowerment in routine breast cancer care: implementation of a remote patient monitoring (RPM) pathway across 24 hospitals in Europe [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO1-10-10.

A Qualitative Analysis of the Impact of Preoperative Mindfulness-Based Stress Reduction on Total Knee Arthroplasty Surgical Experiences

We qualitatively explored the impact of preoperative mindfulness-based stress reduction (MBSR) on total knee arthroplasty (TKA) experiences. Participants (n=10) who received MBSR prior to TKA participated in semi-structured interviews concerning their experiences with MBSR and its perceived impact on surgery. We analyzed interviews according to reflexive thematic analysis, and coded data into three main themes: 1) Impact of MBSR on surgery experiences; 2) Contributors to change; and 3) Motivations for participation. Participants noted they were able to relax, feel more confident, and cope more effectively during the preoperative period, and that others in their lives noticed positive changes following their participation in MBSR. Participants’ openness to mindfulness and health-related beliefs and may have contributed to the positive impacts they experienced from MBSR. Participants described being motivated to participate in MBSR to help them prepare for their surgery and to learn new coping strategies. Participants described a strong level of commitment to the intervention. With further research, integration of MBSR into prehabilitation for TKA may be appropriate.

Fear of Negative and Positive Evaluation as Mediators and Moderators of Treatment Outcome in Social Anxiety Disorder

IntroductionElevated fear of negative evaluation (FNE) and fear of positive evaluation (FPE) are thought to play key roles in the maintenance of social anxiety disorder (SAD). Although efficacious therapies exist for SAD, the potential mediating and moderating effects of FNE and FPE on social anxiety treatment outcome have not been examined. MethodsThis sample comprised a secondary analysis of 210 individuals who participated in one of three randomized controlled trials for the treatment of SAD. Participants were randomized to: individual cognitive behavioral therapy (CBT), group CBT, community mindfulness-based stress reduction (MBSR), group MBSR, or they were randomized to waitlist and offered treatment after waitlist. Assessments were completed pre- and post-treatment/waitlist and, for the treatment groups, at three-month follow-up. ResultsCBT and MBSR led to greater reductions in FNE and FPE than waitlist, with CBT more efficacious in reducing FPE than MBSR. For both CBT (vs. waitlist) and MBSR (vs. waitlist), there were significant indirect effects on post-treatment social anxiety through both FNE and FPE, and the indirect effect through FPE was greater for CBT than MBSR. However, in the fully longitudinal model testing mediation, CBT and MBSR were not differentially mediated by FPE. Baseline FNE and FPE each moderated CBT treatment outcome compared to waitlist – higher baseline FNE and FPE were associated with higher baseline social anxiety and greater reductions in social anxiety during CBT. DiscussionFNE and FPE contributed in sometimes similar and sometimes distinct ways to the mediation and moderation of psychosocial approaches for treating SAD. This supports the importance of distinguishing between fears of negative and positive evaluation in the assessment and treatment of SAD.

Unveiling the mirage of mindfulness profiles through mindfulness-based stress reduction

ObjectivesThe Five Facet Mindfulness Questionnaire (FFMQ) stands out as a standard of mindfulness assessment in scientific literature, although scientific understanding of its properties is still in development. Among them, the FFMQ seems to present latent profiles with specific patterns in its facets. However, no study has explored the behavior of mindfulness profiles across mindfulness-based interventions. This study explores how Mindfulness-Based Stress Reduction (MBSR) impacts mindfulness profiles. MethodsAn overall sample of 624 participants were measured pre and post-MBSR in mindfulness, decentering, self-compassion, psychopathological symptoms, well-being, and positive and negative emotional states. ResultsMBSR altered the structure of latent profiles, shifting from 3 profiles to 2 profiles: A High Mindfulness minority profile and a General Mindfulness majority profile. These profiles could be interpreted as a single dispositional mindfulness continuum. The Judgmentally Observing and Non-Judgmentally Aware profiles were more present in the High Mindfulness profile post-MBSR. All profiles tended to display increased decentering, self-compassion, well-being, and positive states, while decreased negative states and psychological symptoms. Thus, MBSR seemed to “arrange” latent profiles in a continuum of overall mindfulness. ConclusionsMBSR seems to dissipate heterogeneities in the FFMQ, allocating its measurements to a more homogeneous continuum of mindfulness. Implications and recommendations for future studies are discussed.

Effects of mind-body exercise on perimenopausal and postmenopausal women: a systematic review and meta-analysis.

The increasing attention to the management of perimenopausal and postmenopausal women parallels the growth of the aging population. Although hormone therapy is commonly used to alleviate menopausal symptoms, it carries a potential risk of cancer. Recently, mind-body exercises have emerged as innovative approaches for improving menopausal symptoms and bone health. However, research findings have needed to be more consistent, highlighting the significance of this study's systematic review of mind-body exercise effects on perimenopausal and postmenopausal women. This study aims to evaluate the impact of mind-body exercises, including tai chi, yoga, Pilates, qigong, baduanjin, and mindfulness-based stress reduction, on bone mineral density, sleep quality, anxiety, depression, and fatigue among perimenopausal and postmenopausal women. Four electronic databases-PubMed, Embase, Cochrane Central Register of Controlled Trials, and Web of Science-were systematically searched from inception until July 2023. The search focused exclusively on randomized controlled trials to examine the impact of mind-body exercise interventions on perimenopausal and postmenopausal women. The methodological quality of the included studies was evaluated using the Cochrane Bias Risk Assessment tool. A total of 11 randomized controlled trials, comprising 1,005 participants, were included in the analysis. Traditional meta-analysis indicated that mind-body exercise significantly enhanced bone mineral density in perimenopausal and postmenopausal women compared with control groups, with a standardized mean difference (SMD) of 0.41 (95% CI, 0.17 to 0.66; P = 0.001, I2 = 7%). In addition, significant improvements were observed in sleep quality (SMD, -0.48; 95% CI, -0.78 to -0.17; P = 0.002, I2 = 76%), anxiety reduction (SMD, -0.80; 95% CI, -1.23 to -0.38; P = 0.0002, I2 = 84%), depressive mood (SMD, -0.80; 95% CI, -1.17 to -0.44; P < 0.0001, I2 = 79%), and fatigue (SMD, -0.67; 95% CI, -0.97 to -0.37; P < 0.0001, I2 = 0%). The findings of this meta-analysis demonstrate that mind-body exercise positively influences bone mineral density, sleep quality, anxiety, depression, and fatigue among perimenopausal and postmenopausal women.

The effects of mindfulness-based stress reduction on spiritual well-being and hope in patients with breast cancer: A randomized controlled trial.

The effects of mindfulness-based stress reduction on spiritual well-being and hope in patients with breast cancer: A randomized controlled trial.

Comparative effects of exercise interventions and mindfulness-based interventions for cognitive impairment and quality of life in breast cancer survivors during or after cancer treatment: A systematic review and Bayesian network meta-analysis.

The aim of this network meta-analysis was to compare the improvement effects of various exercise interventions and mindfulness-based interventions to determine the best interventions for the improvement of cognitive impairment. 7 databases were searched to screen RCTs of exercise interventions and mindfulness-based interventions to improve cognitive impairment. The network meta-analysis was performed using Revman 5.3, R 4.2.1 and ADDIS 1.16.8 software. 34 RCTs involving 14 interventions were included in the study. In terms of cognitive function, except for mindfulness-based stress reduction, all interventions showed significantly greater improvement in cognitive function compared with conventional therapy. Physical activity and Qigong showed better effect in improving executive function. In terms of improving verbal memory, compensatory cognitive training, neurofeedback training, Qigong and sham Qigong were more effective than other interventions. On performing surface under the cumulative ranking curve analysis, acceptance and commitment therapy, neurofeedback training, Qigong, and mediation had the best effects on cognitive function, quality of life, executive function, and processing speed, respectively. Mindfulness-based interventions were found to be more effective than exercise interventions for alleviating cognitive impairment. More robust RCTs focusing on acceptance and commitment therapy for cognitive impairment are required to support the current evidence.

An online self-study mindfulness-based stress reduction course for people suffering from mental fatigue after an acquired brain injury

ABSTRACT Objective The Mindfulness-Based Stress Reduction (MBSR) program has shown promising results for people suffering from mental fatigue after an acquired brain injury. The aim was to evaluate the feasibility of a MBSR program performed as an online self-study course for this group of people. Methods Sixty participants who had suffered an acquired brain injury with lasting mental fatigue were randomized to an online MBSR course or to a waitlist control group. They answered self-report questionnaires before start and after the course. Results Sixteen completed the MBSR program. With the repeated ANOVA no significant difference between groups was found, although there was a significant change in time (the repetition factor). The post-hoc paired t-test indicated a significant reduction and a large-to-median effect size in mental fatigue (p = 0.003, d = 0.896), depression (p = 0.038, d = 0.569) and anxiety (p = 0.030, d = 0.598) for the MBSR group. No significant changes were found for the control group. Conclusion An online self-study MBSR program for people suffering from mental fatigue after an acquired brain injury can be a feasible option for those suffering from less severe mental fatigue and emotional symptoms, while others may require a program adapted to their needs.

The Clinical Efficacy of Different Relaxation Exercises on Intraocular Pressure Reduction: A Meta-Analysis.

Objective: The aim of this study was to synthesize the available evidence on the clinical efficacy of different relaxation exercises on intraocular pressure (IOP) reduction. Methods: A systemic search of PubMed, Embase, Cochrane CENTRAL, and Web of Science was undertaken from the earliest record to 10 April 2024. Peer-reviewed studies that reported on healthy individuals and glaucoma patients engaging in relaxation exercises for at least three weeks were included. The primary outcome was changes in IOP levels from baseline, before the commencement of relaxation exercises, to post-exercise. Our statistical analysis employed a random-effects model, with effect sizes reported using Hedges' g. Results: Twelve studies were included, totaling 764 eyes (mean participant age ranging from 21.07 to 69.50 years). Relaxation exercises significantly reduced IOP, with Hedges' g being -1.276 (95% CI: -1.674 to -0.879) and I2 = 84.4%. Separate subgroup analyses showed that breathing exercises (Hedges' g = -0.860, p < 0.0001), mindfulness-based stress reduction (MBSR) (Hedges' g = -1.79, p < 0.0001), and ocular exercises (Hedges' g = -0.974, p < 0.0001) were associated with reduced IOP levels. The reduction in IOP following the relaxation exercises was found to be associated with baseline IOP either greater than (Hedges' g = -1.473, p < 0.0001) or less than 21 mmHg (Hedges' g = -1.22, p < 0.0001). Furthermore, this effect persisted with follow-up durations of less than (Hedges' g = -1.161, p < 0.0001) and more than one month (Hedges' g = -1.324, p < 0.0001). Conclusions: The current meta-analysis indicates that relaxation exercises can significantly reduce IOP levels. Relaxation exercises are a potential class of novel treatments for glaucoma patients that deserve further evaluation.

Serotonin Transporter (SLC6A4) and FK506-Binding Protein 5 (FKBP5) Genotype and Methylation Relationships with Response to Meditation in Veterans with PTSD.

Meditation-based interventions are novel and effective non-pharmacologic treatments for veterans with PTSD. We examined relationships between treatment response, early life trauma exposure, DNA polymorphisms, and methylation in the serotonin transporter (SLC6A4) and FK506-binding protein 5 (FKBP5) genes. DNA samples and clinical outcomes were examined in 72 veterans with PTSD who received meditation-based therapy in two separate studies of mindfulness-based stress reduction (MBSR) and Transcendental Meditation (TM). The PTSD Checklist was administered to assess symptoms at baseline and after 9weeks of meditation intervention. We examined the SLC6A4 promoter (5HTTLPR_L/S insertion/deletion + rs25531_A/G) polymorphisms according to previously defined gene expression groups, and the FKBP5 variant rs1360780 previously associated with PTSD disease risk. Methylation for CpG sites of SLC6A4 (28 sites) and FKBP5 (45 sites) genes was quantified in DNA samples collected before and after treatment. The 5HTTLPR LALA high expression genotype was associated with greater symptom improvement in participants exposed to early life trauma (p = 0.015). Separately, pre to post-treatment change of DNA methylation in a group of nine FKBP5 CpG sites was associated with greater symptom improvement (OR = 2.8, 95% CI 1.1-7.1, p = 0.027). These findings build on a wealth of existing knowledge regarding epigenetic and genetic relationships with PTSD disease risk to highlight the potential importance of SLC6A4 and FKBP5 for treatment mechanisms and as biomarkers of symptom improvement.

Application of mindfulness-based interventions – MBCT and MBSR – in depression treatment and relapse prevention

Introduction: Depression stands as a primary contributor to disability, prompting extensive exploration of treatment and prevention strategies. Recognizing the limitations of conventional approaches, the significance of effective non-pharmacological therapies, like psychotherapy, in managing mental health disorders is increasingly acknowledged. There's a growing interest in mindfulness-based interventions such as Mindfulness-Based Cognitive Therapy (MBCT) and Mindfulness-Based Stress Reduction (MBSR). These interventions, which prioritize present-moment awareness and acceptance, target depression's mechanisms, such as rumination, while cultivating coping strategies and resilience. Mindfulness, with its comprehensive approach and capacity for self-regulation, emerges as pivotal in addressing psychiatric conditions. This paper aims to provide a comprehensive evaluation of MBCT and MBSR's effectiveness in treating depression and preventing relapses. Description of the state of knowledge: MBCT and MBSR exhibit promising potential in effectively managing and preventing depression. Moreover, they alleviate anxiety, emotional exhaustion, stress and psychological distress, while fostering improved coping with rumination, memory disturbances and emotional regulation. Summary: Research indicates that incorporating MBCT and MBSR could offer a hopeful avenue for managing and alleviating the symptoms of depression and mental disorders, by addressing underlying factors which play a pivotal role in their development. To corroborate these encouraging results, additional randomized, large-scale, placebo-controlled trials are essential.

Application of mindfulness-based interventions – MBCT and MBSR – in depression treatment and relapse prevention

Introduction: Depression stands as a primary contributor to disability, prompting extensive exploration of treatment and prevention strategies. Recognizing the limitations of conventional approaches, the significance of effective non-pharmacological therapies, like psychotherapy, in managing mental health disorders is increasingly acknowledged. There's a growing interest in mindfulness-based interventions such as Mindfulness-Based Cognitive Therapy (MBCT) and Mindfulness-Based Stress Reduction (MBSR). These interventions, which prioritize present-moment awareness and acceptance, target depression's mechanisms, such as rumination, while cultivating coping strategies and resilience. Mindfulness, with its comprehensive approach and capacity for self-regulation, emerges as pivotal in addressing psychiatric conditions. This paper aims to provide a comprehensive evaluation of MBCT and MBSR's effectiveness in treating depression and preventing relapses. Description of the state of knowledge: MBCT and MBSR exhibit promising potential in effectively managing and preventing depression. Moreover, they alleviate anxiety, emotional exhaustion, stress and psychological distress, while fostering improved coping with rumination, memory disturbances and emotional regulation. Summary: Research indicates that incorporating MBCT and MBSR could offer a hopeful avenue for managing and alleviating the symptoms of depression and mental disorders, by addressing underlying factors which play a pivotal role in their development. To corroborate these encouraging results, additional randomized, large-scale, placebo-controlled trials are essential.

Effectiveness of Individual-Based Strategies to Reduce Nurse Burnout: An Umbrella Review

Aims. This umbrella review aims to comprehensively synthesize and analyze the findings of available systematic reviews on the effectiveness of individual-based strategies for reducing nurse burnout occurring in hospital-based settings. Methods. Following JBI guidelines, an umbrella review was conducted to integrate the effectiveness of various strategies to reduce burnout. Systematic reviews were searched in the Embase, MEDLINE (Ovid), Cochrane Library, CINAHL (EBSCO), Scopus, and WOS databases. Inclusion criteria included studies published in any language from database inception to April 2023. Eligibility assessment involved two independent reviewers who evaluated titles, abstracts, and full texts. The systematic reviews were critically evaluated using JBI SUMARI. The results were narratively synthesized and grouped by strategy. Results. Eleven systematic reviews were included, covering the years 2012 to 2021. The appraisal tools varied, though all included reviews were of high quality. The strategies were categorized into three domains: mental health (51%), physical activities (26%), and professional competence (13%). The interventions most identified were mindfulness-based stress reduction for mental health, yoga for physical activities, and professional competence education. These individual-based strategies were shown to effectively eliminate emotional exhaustion (72.7%), depersonalization (44%), and occupational stress (78%) among nurses in hospital-based settings. Conclusion. Mental health, physical activities, and professional competence are strategies to reduce nurse burnout. Implementing these approaches in healthcare settings can improve emotional exhaustion, depersonalization, and occupational stress of nurses.

Mindfulness, spiritual well-being, and sustainable consumer behavior

Although there has been considerable research interest in how mindfulness affects consumers’ pro-environmental behaviors, extant research has not fully clarified the underlying mechanisms through which mindfulness is related to sustainable consumption. This study examines mediating effects of spiritual well-being in regard to the relationship between mindfulness and sustainable consumer behavior. Four different types of sustainable consumer behavior are examined: general ethically minded consumer behavior, voluntary simplicity, direct environmental behavior, and support for green products. The study was conducted with 467 French consumers: 208 consumers who have undertaken formal mindfulness training (mindfulness-based stress reduction program) and 259 consumers who have never undertaken any mindfulness training. The findings show that mindfulness is related to sustainable consumer behavior through the personal, communal, and environmental domains of spiritual well-being. However, the links between mindfulness and spiritual (personal, communal, and environmental) well-being are primarily evident only among consumers who have undertaken formal mindfulness training. Thus, this research demonstrates how mindfulness affects sustainable consumer behavior and identifies conditions under which these effects are observed. Policy recommendations in the form of supporting and subsidising mindfulness training programs and other initiatives that enhance spiritual well-being, to facilitate greater sustainable consumer behavior are proposed.