Significant Decrease In Anxiety Research Articles

Mindfulness in Surgical Training (MiST): A Modified Mindfulness Curriculum for Surgical Residents

Residents experience numerous work-related and personal stressors that make it difficult to focus in the operating room, negatively impacting learning and surgical performance. Mindfulness-based cognitive therapy decreases anxiety and improves memory and learning. This study aimed to create a feasible and desirable modified mindfulness curriculum for surgical residents. This was a prospective cohort study using multiple methods design to assess a 12-week modified mindfulness curriculum tailored to busy surgical trainees involving a 30 min group session weekly and 15 minutes home practice daily. The main outcomes were program feasibility and desirability. Focus groups explored how mindfulness techniques were used in the operating room. Secondary outcomes were measured in a pre- and post- intervention design assessing surgical performance, anxiety, confidence and burnout using validated assessment scales. Outcome measures were collected at baseline, immediately following the course and at 3 months postintervention. Academic obstetrics and gynecology residency program. Obstetrics and gynecology residents in postgraduate years 2-5 at the University of Toronto were invited to participate in Mindfulness in Surgical Training. Twelve (20%) out of 61 eligible residents enrolled in the program and 8 (67%) completed the course. There was a statistically significant decrease in anxiety (p < 0.001) and increase in surgical confidence (p = 0.007) following the mindfulness curriculum using validated survey tools. There was no change in burnout or surgical performance evaluations. Thematic analysis identified that mindfulness tools were beneficial and regularly utilized by participants in the operating room with sustained use 3 months post intervention. The biggest barrier to participation in the mindfulness curriculum was time. Participants felt the residency program should support ongoing mindfulness training to promote a positive culture shift. A modified mindfulness curriculum designed for surgical trainees is feasible, desirable, reduces anxiety and increases surgical confidence.

Strengths use and emotional disorder symptom reduction during a transdiagnostic cognitive behavioral therapy: A random-intercept cross-lagged panel model study.

Strengths use, the engagement of positive character traits in everyday contexts, is associated with both positive functioning and symptom reduction. The present study examined longitudinal relationships between strengths use and emotional disorder symptoms (anxiety, stress, and depression) during a randomized clinical trial of the Digital Unified Protocol, a transdiagnostic cognitive behavioral therapy. Participants (N = 120) completed assessments at four major time points during treatment and at 3-month follow-up. We specified three random-intercept cross-lagged panel model to capture within-person, bidirectional, time-lagged relationships between strengths use and anxiety, stress, and depression, respectively. Prospective increases in strengths use were associated with significant decreases in anxiety at all time points (β = -0.26 to -0.49), while prospective decreases in anxiety were associated with significant increases in strengths use at most time points (β = -0.25 to -0.36). Prospective increases in strengths use were associated with significant decreases in stress at most time points (β = -0.23 to -0.54), while prospective decreases in stress were associated with significant increases in strengths use at Week 4 (β = -0.21) and at follow-up (β = -0.41). Prospective increases in strengths use were associated with significant decreases in depression at Week 8 (β = -0.63) and at posttreatment (β = -0.67), while prospective decreases in depression were associated with significant increases in strengths use at most time points (β = -0.34 to -0.47). Clinical implications of findings are discussed, including the potential role of strengths use as a treatment target. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Relationship of anxiety and depression with smoking cessation treatments: a follow-up study

ABSTRACT Background Smoking is known to be closely associated with a stress levels and anxiety. In this study, the effects of smoking cessation treatments were investigated on anxiety/depression. Methods Socio-demographic characteristics The Fagerström/Test/Nicotine/Dependence, the Hospital Anxiety and Depression (HAD) scale were applied at first time. The first group received “varenicline+counseling,” second group “bupropion+counseling,” and third group “counseling only.” The HAD scores were recorded in quit smokers. Anxiety and depression scores were compared between groups and between smokers and ex-smokers in the first and sixth month. Results Firstly, The HAD scores revealed that anxiety was present in 46.8%, depression in 11.2%, anxiety and/or depression in 48.9%. A significant decrease in both anxiety and depression scores was observed in quit smokers at 6 months (47.9% and 37.4%, respectively) (p < .001). At the sixth month, there was a significant decrease in anxiety scores in the varenicline and bupropion groups. In addition, a significant decrease in the depression score was observed in the varenicline group. In the bupropion group, the smoking cessation rate was higher in those with high anxiety and/or depression scores (66.7%). Conclusions Varenicline decreased anxiety/or depression scores in both smokers and quit smokers, whereas quit smoking rate increased in those with anxiety/depression in the bupropion.

AN ANALYTICAL STUDY OF NUTRITIONAL STYLE, NUTRITIONAL STATUS, AND MENTAL HEALTH IN THE PRECONCEPTION PERIOD : (TOWARDS OPTIMAL PREGNANCY OUTCOMES)

Background: The preconception period is a crucial period to optimize maternal and fetal health. Preconception nutrition can affect nutritional status and mental health which has an impact on pregnancy readiness. This study aims to analyze the correlation between nutrition and nutritional status and mental health during the preconception period. Method: This study used a prospective cohort study involving women of childbearing age selected by stratified random sampling to obtain 129 respondents. Nutritional Style data were collected through FFQ questionnaires, nutritional status was measured through anthropometry and Hemoglobin examination, and mental health was measured using the DASS questionnaire. Data collection was carried out three times and analyzed using the Pearson correlation test, multiple linear regression and the Wilcoxon test for longitudinal analysis. Result: The results showed that there was no significant correlation between Nutritional Style and BMI (p-value&gt;0.05). However, there was a significant correlation between Nutritional Style and the incidence of anemia, the strongest correlation in the first measurement (p-value 0.001) and the second measurement (p-value 0.049). A significant correlation was found between Nutritional Style and mental health, especially anxiety in the first measurement (p-value 0.022), the second measurement (p-value 0.006) and the third measurement (p-value 0.029), but not with stress and depression. There was a significant increase in nutritional status from the first to the second measurement (p-value 0.020) and the first to the third measurement (p-value 0.003). There was a significant decrease in anxiety from the first to the second measurement (p-value 0.034) and the first to the third measurement (p-value 0.000). Conclusion : Good Nutritional Style during preconception can improve nutritional status and minimize mental health risk. Nutrition intervention programs are needed to improve knowledge and implementation of healthy food nutrition. In addition, regular monitoring of nutritional status and mental health is also needed to optimize pregnancy readiness.

Physical Exercise and Mental Health in Adolescents: Scoping Review

Objective. To identify the most implemented exercises and their prescription, in addition to the effects of exercise on mental health in adolescents. Methods. A scoping review was performed from search of electronic databases: PubMed, Science Direct, Scopus, Springer, Google Scholar, from 23/08/2023 to 01/01/2024 in English, Spanish, and Portuguese language, including randomized clinical trial and cohort type studies. Results. A total of 7 articles were included: 57.14% controlled clinical trials, 100% in English. The number of participants was 85,637 aged 12 to 16 years. Intervention time ranged from 8 to 43 weeks, 2 to 5 times per week, 1 session per day, duration per session 10 to 120 minutes. The most used type of training was Programmed Physical Education followed by High Intensity Interval Training. Conclusions. Exercises such as Programmed Physical Education, High Intensity Interval Training, Moderate to Vigorous Physical Activity are included, which show positive effects on the increase in psychological well-being, quality of life and a significant decrease in anxiety and stress symptoms.

Comparative Outcomes of a Cognitive-Behavioral Skills Building Program on the Mental Health and Healthy Behaviors of Prenursing Students

Background: Nursing students experience significantly more stress related diseases when compared to non-nursing students, and the state of their mental health can result in short-term increased attrition rates and increased nursing shortages. Purpose: A preexperimental pre-post study design was used to examine mental health and healthy behaviors among prenursing students. Methods: Cohorts received the MINDSTRONG© program either in-person or virtually. Data analysis included Personal Wellness Assessments completed at both pre- and poststudy for all participants (n = 110). Results: Both groups postintervention had statistically significant decreases in anxiety, depression, and stress and statistically significant increases in healthy lifestyle behaviors and beliefs. Students with elevated depression and anxiety scores at baseline had greater decreases postintervention than the overall groups. Conclusion: The outcomes for both cohorts were positive and effective in reducing stress, anxiety, and depressive symptoms. Healthy behaviors were improved and align with findings with an in-person format. Findings from this study support implementation of MINDSTRONG in synchronous sessions, either in-person or virtual.

Expanding Access to Mental Health: Evaluating the Potential of a Serious Mental Health Game for Adolescents.

Digital technologies are important for expanding access to mental health support in low-resource settings. The current study tests the feasibility of a blended learning mental health intervention that was implemented for adolescents in Lebanon (N = 1,234), most of whom were Syrian refugees. The intervention features a digital game called The Helping Hand, which teaches adolescents how to respond to psychosocial challenges healthily and develop effective coping strategies. The blended learning intervention was tested using a single-arm, non-blinded, mixed-methods approach, through the analysis of pre-post questionnaires and key informant interviews. Results showed that the intervention was well accepted and popular among participating adolescents and the team that implemented it. After completing the intervention, adolescents showed a significant decrease in anxiety and depression symptoms and a significant increase in overall well-being. The feasibility and potential impact observed in this study demonstrate the benefits of continuing to refine and expand digital interventions that improve access to mental health support for vulnerable populations.

Peer‐provided problem management plus (PM+) and case management for Arabic‐speaking and Farsi‐speaking refugees and asylum seekers in Greece

AbstractAn increasingly common response to the lack of specialist mental health services for refugees and asylum seekers in European host countries is peer‐supported services. This study examined the association between a peer‐provided psychosocial intervention and psychological symptom reduction among refugees and asylum seekers in Greece. The intervention consisted of Problem Management Plus (PM+) and peer case management sessions delivered by a team of Community Psychosocial Workers (trained refugees). The sample consisted of 173 participants, comprising Arabic and Farsi speakers, male and female participants, recognized refugees and asylum seekers. Anxiety, depression, and psychological distress were measured before and after the intervention using the Patient Health Questionnaire‐9, Generalized Anxiety Disorder‐7, and Psychological Outcome Profiles scales, respectively. Repeated measures analysis of variance was adopted to evaluate the difference in the degree of change across patient characteristics over the follow‐up period. The level of statistical significance was set at p &lt; .05, and analyses were conducted using SPSS statistical software (version 26.0). Significant decreases were found in all postintervention scores, indicating significant decreases in anxiety and depression symptoms as well as in psychological distress following the peer‐provided psychosocial intervention, which included emotional support and social care. Large effect sizes were found at all scales. The findings support the notion that there is an association between the implemented intervention and symptom reduction in refugees. For future research, a randomized controlled trial is proposed as a study protocol.

The impact of group cognitive behavioral psychotherapy on disease severity and psychosocial functioning in patients with inflammatory bowel disease: a randomized controlled study.

Patients with inflammatory bowel disease (IBD) often report symptoms of anxiety and depression as well as impaired quality of life (QoL). To date, there are few studies on the effect of psychotherapy on psychological functioning and clinical outcome in patients with IBD. The aim of this prospective, randomized, controlled study was to investigate the effect of a brief psychotherapeutic intervention on psychological distress, QoL, sexual functioning, and inflammation and disease activity indices in patients with IBD. Participants were randomized to receive either group cognitive behavioral therapy or treatment as usual (controls) and were assessed at baseline and after six months using psychometric instruments to assess psychological distress, QoL, and sexual functioning. In addition, laboratory measurements, including levels of C-reactive protein (CRP), cytokines and calprotectin, and calculations of disease activity indices were performed during the two study periods. 80 participants took part in the study. Patients who received psychotherapy reported a significant decrease in anxiety and depression symptoms, a significant improvement in physical functioning, general health, vitality, social functioning and mental health, a decrease in physical pain and a decrease in role limitations caused by emotional problems. CRP levels and the Crohn's disease activity index (CDAI) also decreased significantly at follow-up compared to controls. Group cognitive behavioral therapy is proving to be an important component of holistic care for IBD patients, as it can significantly improve not only patients' psychosocial functioning but also their clinical course by inhibiting inflammation and reducing disease activity.

The effectiveness of live music in reducing anxiety and depression among patients undergoing haemodialysis. A randomised controlled pilot study.

Anxiety and depression are highly prevalent disorders among individuals undergoing chronic haemodialysis. For patients with kidney disease, the haemodialysis process often exacerbates these conditions. This study aims to investigate the effects of listening to live classical music on anxiety and depression scales during haemodialysis sessions. A randomised clinical trial was conducted with a group of patients who listened to live classical music during haemodialysis sessions, while the control group received treatment as usual. Anxiety and depression levels were assessed at baseline and after 4 weeks of listening to live music. The study comprised 90 patients. The results demonstrated a significant decrease in anxiety and depression among the intervention group, who listened to music, compared to the control group, who did not receive this intervention. Specifically, the intervention group, presented a decrease in score on the anxiety scale of -5.35 (p < 0.001) points on average and a decrease in score on the depression scale of -5.88 (p < 0.001) points on average, while in the control group the levels worsened with the progression of time. It is concluded that listening to live classical music during haemodialysis sessions reduces anxiety and depression levels in HD patients. This conclusion adds value to listening to live music in the hospital context, specifically in this case, in haemodialysis rooms.

Effect of Comprehensive Nursing Intervention on Anxiety and Quality of Life inPostoperative Patients with Oral Cancer

Purpose: Surgery has a negative effect on the mental, physical, and functional health of patients with oral cancer, which affects their quality of life (QOL). The study aimed to assess the effect of comprehensive nursing intervention on anxiety and QOL in postoperative patients with oral cancer. Methods: We investigated the level of anxiety and QOL of 200 postoperative oral cancer patients. After the comprehensive nursing intervention, the Beck Anxiety Inventory scale and European Organization for Research and Treatment of Cancer tools were used to assess the level of anxiety and QOL, respectively. Results: There was a statistically significant difference in terms of educational status (p=0.02), monthly income (p&lt;0.01), cancer stage (p&lt;0.01), and tumor metastasis (p=0.02). The experimental group experienced a significant decrease in anxiety (p=0.04), and their QOL was significantly higher (p=0.05) than that of the control group. Conclusion: Our study indicates that a comprehensive nursing intervention can lower the risk of surgical complications, enhance patients' psychological state by reducing anxiety, and enhance their QOL in patients with oral cancer.

Development and Preliminary Efficacy of a Mindfulness-Based Counseling Program as Part of Comprehensive Cardiac Rehabilitation: A Pilot Study

Background: While psychological intervention is recognized as a core component of cardiac rehabilitation (CR), its application in CR remains limited. This study aimed to develop a psychological counseling program (the Mindfulness-Based Counseling Program [MBCP]) as a component of comprehensive CR for the patients with cardiovascular disease and to explore its preliminary efficacy.Methods: We developed a psychological counseling program (MBCP) as part of comprehensive CR. The MBCP consisted of six-week psychological counseling and mindfulness practice. Through this program, we aimed to promote health maintenance behaviors and stress management. Thirteen subjects with either acute myocardial infarction or congestive heart failure with reduced EF (≤40%) participated, randomized into either comprehensive CR including MBCP (n=7) or exercise-based CR (n=6). Psychological-status assessments included life satisfaction (DSQ), health-related quality of life (HRQoL), depression (PHQ-9), anxiety (GAD-7), type D personality, and stress (PSS).Results: The comprehensive CR group (n=7) experienced a significant decrease in anxiety and improvements in general health and mental aspects of HRQoL. The exercise CR group (n=6) experienced reduced depression and significantly increased mental aspects of HRQoL. Additionally, the overall satisfaction and participation rate for MBCP was high.Conclusions: The MBCP developed in this study showed preliminary efficacy for CR and is anticipated to enhance psychological wellbeing and the quality of life among cardiac patients.

Effects of Brain Gym Exercises on Attention and Anxiety in Adolescents – An Experimental Study

Background: The common psychological difficulties in adolescents are anxiety states or minor depression and apart from that the attention span in adolescents is also shrinking as reported. The Brain Gym exercise is said to release learning blocks and cause improvement in areas such as memory, concentration, and focus. The goal of this study is to improve anxiety and attention in adolescents by performing brain gym exercises. Aim: To study the effects of brain gym exercise on attention and anxiety in adolescents. Methodology: The study employed an experimental study including 134 students within a 15-19 years age group, selected through purposive sampling. The primary outcomes are the Hamilton anxiety rating scale and the mindful attention awareness scale. Brain gym exercise was performed thrice a week for four weeks. Results: A statistically significant improvement in anxiety and attention is observed with using brain gym exercise. The pretest mean anxiety score at week 1 was 18.46 and after four weeks the results showed a statistically significant decrease in anxiety with a mean score of 16.14. The pretest attention score in week 1 was 3.67 and the post-intervention score in week 4 was 3.98 showing a statistically significant increase in attention. The data was statistically significant with a p-value of &lt;0.05. Conclusion: The study concludes there’s a significant effect of brain gym exercises in improving attention and anxiety. KEYWORDS: Brain Gym Exercise, Anxiety, Attention, Adolescents, Hamilton Anxiety Rating Scale, The Mindful Attention Awareness Scale.

A Web-Based Intervention Using "Five Ways to Wellbeing" to Promote Well-Being and Mental Health: Randomized Controlled Trial.

Compromised well-being and mental health problems pose a significant threat to individuals and societies worldwide. Resource-intensive psychological treatments alone cannot alleviate this burden. There is a need for low-cost, evidence-based interventions aimed at preventing illness and promoting well-being. Five activity domains appear to be linked with well-being promotion across populations: connecting with others, being active, taking notice, learning, and being generous/giving. The activities mentioned are part of the Five Ways to Wellbeing framework and the web-based intervention Five Ways to Wellbeing for All (5waysA). This randomized controlled trial aims to test the effects of the 5waysA intervention, a web-based, low-cost, well-being-promoting measure targeting the general population. To date, the Five Ways to Wellbeing framework has not been tested in this specific format. The 5waysA intervention comprises 2 webinars and SMS text message reminders delivered over a 10-week period. In 2021, a total of 969 study participants from various regions across Norway were openly recruited through a web page. They were then randomly assigned to either an intervention group or 1 of 2 waiting list control groups, namely, active or passive. Self-reported life satisfaction (Satisfaction With Life Scale [SWLS]), flourishing (Flourishing Scale [FS]), positive emotions, anxiety, and depression symptoms (Hopkins Symptom Checklist-8 [HSCL-8]) were assessed before the intervention, at 4 weeks into the intervention, and 1-2 weeks after the intervention (over 10 weeks). Data analysis was conducted using linear mixed (multilevel) models. After 10 weeks, 453 participants (171 in the intervention group and 282 in the waiting list control group) were assessed on outcome variables, with a dropout rate of 53.2% (516/969). Results revealed a significantly greater increase in the intervention group compared with the controls for SWLS (b=0.13, 95% CI 0.03-0.23; P=.001), FS (b=0.19, 95% CI 0.08-0.30; P=.001), positive emotions (b=0.43, 95% CI 0.27-0.60; P<.001), and these factors combined into a global well-being measure (b=0.28, CI 0.16-0.39; P<.001). Effect sizes (Cohen d) for the well-being outcomes ranged from 0.30 to 0.49. In addition, a significant decrease in anxiety and depressive symptoms was observed (b=-0.17, 95% CI -0.30 to -0.04; P=.001) with an effect size (Cohen d) of -0.20. The findings suggest that the web-based 5waysA intervention could serve as an effective approach for enhancing well-being and mental health within the general population. This study offers individuals, policy makers, and local stakeholders an accessible and potentially cost-effective well-being intervention that could be easily implemented. ClinicalTrials.gov NCT04784871; https://clinicaltrials.gov/study/NCT04784871.

A resiliency intervention adapted for older women with HIV: Results from a pilot randomized controlled trial in the northeastern US.

Aging with HIV often results in psychosocial and health-related challenges for women; however, no resiliency interventions exist for older women with HIV (WWH). WWH aged ≥50 were randomized to 10 group sessions of an adapted resiliency intervention or time-matched supportive psychotherapy. Assessments were conducted at three timepoints. Feasibility and acceptability metrics were defined a priori; differences in resilience, stress coping, anxiety, and depression across timepoints were assessed. Overall, 44 WWH enrolled; participants were 58 years old on average, and 56.4% identified as Black/African American. Among those who attended any sessions, all feasibility metrics were met, and the intervention was acceptable. The interaction of study arm and time was associated with significant decreases in depression and a trend toward significant decreases in anxiety. The intervention was not associated with changes in resilience or stress coping. Adjusting delivery modality may further reduce barriers to attendance, improving feasibility and clinical outcomes.

Modernizing ED Care: Virtual Reality Enhances the Patient Experience during Minor Wide-awake Hand Procedures.

Minor procedures in the emergency department (ED) can be distressing for patients. The emergence of virtual reality (VR) offers a promising new tool by immersing patients in an engaging three-dimensional world. Prior studies have shown VR's effectiveness during procedures in reducing pain, anxiety, and procedure duration but have not assessed its efficacy in the ED. This study aims to evaluate the efficacy of VR in managing pain and anxiety during ED minor hand procedures. This was a prospective, interventional study at a level I trauma center examining adult patients requiring minor hand procedures. Patients were provided the Oculus Quest 2 VR headset, offering various immersive three-dimensional experiences. Pre- and postprocedure surveys assessed previous VR use, anxiety and pain levels, VR efficacy, and possible adverse effects. Responses were rated on a 10-point Likert scale with paired t tests used to compare scores. The study included sixteen patients, seven of whom were first-time VR users. Patients experienced a significant decrease in both anxiety and pain levels. Survey results indicated overall benefits from VR in several aspects, with no adverse effects reported, and unanimous patient recommendation of the VR experience to others. VR is an effective tool to optimize the patient experience during ED hand procedures. The study observed a significant decrease in anxiety and a declining trend in pain levels. Patients believed VR helped manage their pain and would recommend it to others. Given the benefits and high safety profile, VR should become a standard offering in ED minor hand procedures.

Effects of Safe and Sound Protocol on self-reported autonomic reactivity, anxiety, and depression in speech therapy clients with voice, throat, and breathing complaints

Medically unexplained oto-rhino-laryngeal symptoms (MUORLS) may have a pathophysiology related to brain-body state regulation. We use predictions from the Polyvagal Theory to investigate whether clients with voice problems have increased autonomic reactivity, anxiety, and depression. Study 1 included 54 clients with MUORLS, and a comparison group of 26 individuals without MUORLS. Outcome measures were anxiety and depression (Hospital Anxiety and Depression Scale, HADS), autonomic reactivity (Body Perception Questionnaire Short Form, BPQ-SF), and extent of voice handicap (The Voice Handicap Index, VHI) for the clients. The client group scored higher than the control group in supra-diaphragmatic reactivity, but there were no group differences in other measures. To extend the findings of Study 1, a feasibility study (Study 2) evaluated the effects of the Safe and Sound Protocol (SSP), a Polyvagal-informed protocol, on the same outcome measures. Study 2 included 33 clients with self-reported voice and throat complaints. Outcome measures assessed pre- and post-SSP were anxiety and depression (HADS) and autonomic reactivity (BPQ-SF). Results demonstrated a significant decrease in anxiety, depression, and autonomic reactivity post-SSP. In conclusion, a better understanding of the mechanisms that underlie MUORLS may provide guidance for using neurophysiologically based interventions, such as SSP, that target autonomic state regulation.

Up-to-date approach to cardiorehabilitation of post-myocardial infarction persons

The article considers the possibility of using a multimodal cardiorehabilitation program for post-myocardial infarction people in accordance with the updated Regulations of the European Society of Cardiology. It is noted that myocardial infarction is the main cause of limitation of physical activity, loss of working capacity, disability and sudden death among the population. The purpose of the study is to develop of a multimodal cardiorehabilitation program for post-myocardial infarction people and to evaluate its effectiveness. Research material and methods are: analysis of scientific and methodological literature by the research topic; analysis of medical documentation; methods of researching the functional state of the cardiovascular system; bicycle ergometric test with intermittently increasing load; Borg Rating of Perceived Exertion Scale; Hospital Anxiety and Depression Scale (HADS); methods of mathematical statistics. The results. It is shown that under the impact of multimodal cardiorehabilitation, in the main group of patients at the end of the intervention, there is a significant increase in almost all the investigated indicators. An increase in the traveled distance (m) in the 6-minute test according to the classification of the New York Heart Association (NYHA) made it possible to transfer the majority of patients to the II functional class of cardiac insufficiency. A bicycle ergometric test with an intermittently increasing load showed an increase in the overall endurance of the organism of the main group of tested people and correlated with the 6MWT indicators. The subjective feelings of post-myocardial infarction patients during exercise, which were evaluated by the 10-point Borg Rating of Perceived Exertion Scale, improved, and a significant decrease in anxiety, emotional disorders, and depression according to the Hospital Anxiety and Depression Scale (HADS) was noted. In the control group, there was a significant increase only in the 6MWT indicator, which indicates an increase in the adaptive capabilities of the cardiovascular system, and not an increase in the overall endurance of the organism of the tested people. Conclusions. A multimodal approach to cardiorehabilitation in the light of updated intervention protocols for patients with myocardial infarction will significantly contribute to the optimization of the cardiovascular system and the faster return of patients to a full life.

Effects of Two Group Prenatal Care Interventions on Mental Health: An RCT

Perinatal depression and anxiety cost the U.S. health system $102 million annually and result in adverse health outcomes. Research supports that cognitive behavioral therapy improves these conditions, but barriers to obtaining cognitive behavioral therapy have prevented its success in pregnant individuals. In this study, the impact of a cognitive behavioral therapy-based intervention on anxiety, depression, stress, healthy lifestyle beliefs, and behaviors in pregnant people was examined. This study used a 2-arm RCT design, embedded in group prenatal care, with one arm receiving a cognitive behavioral therapy-based Creating Opportunities for Personal Empowerment program and the other receiving health promotion content. Black and Hispanic participants (n=299) receiving prenatal care from 2018 to 2022 in New York and Ohio who screened high on 1 of 3 mental health measures were eligible to participate. Participants were randomized into the manualized Creating Opportunities for Personal Empowerment cognitive behavioral therapy-based program, with cognitive behavioral skill-building activities delivered by advanced practice nurses in the obstetrical setting. Outcomes included anxiety, depression, and stress symptoms using valid and reliable tools (Generalized Anxiety Disorder scale, Edinburgh Postnatal Depression Scale, and Perceived Stress Scale). The Healthy Lifestyle Beliefs and Behaviors Scales examined beliefs about maintaining a healthy lifestyle and reported healthy behaviors. There were no statistically significant differences between groups in anxiety, depression, stress, healthy beliefs, and behaviors. There were significant improvements in all measures over time. There were statistically significant decreases in anxiety, depression, and stress from baseline to intervention end, whereas healthy beliefs and behaviors significantly increased. Both cognitive behavioral therapy and health promotion content embedded in group prenatal care with advanced practice nurse delivery improved mental health and healthy lifestyle beliefs and behaviors at a time when perinatal mood generally worsens. This study is registered with clinicaltrials.gov NCT03416010.

A Randomized Controlled Trial Comparing the Effect of Tracheostomy Training using Mannequin-Based Simulation and Smartphone Application on Self-Efficacy and Anxiety of Caregivers.

Inefficient education is a cause of anxiety and low self-efficacy among caregivers, especially for those caring for patients with tracheostomy. This randomized controlled trial aimed to compare the outcomes of tracheostomy care education by mannequin-based simulation and smartphone application. The participants were 126 primary caregivers of tracheostomy patients being discharged home from hospitals affiliated with Tehran University of Medical Sciences. The control group received routine care. Caregiver self-efficacy was assessed using the Caregiver Inventory and the Hamilton Anxiety Rating Scale prior to the education and 1 month after. There were significant differences among the three groups regarding the mean scores of self-efficacy and anxiety. There was a significant increase in self-efficacy (P ≤ .0001) and a significant decrease in anxiety (P ≤ .0001) scores after the intervention. The intergroup comparison showed a significant difference between the intervention groups and the control group in terms of changes in the anxiety and self-efficacy scores of caregivers (P < .001).