Underuse of Yoga as a Referral Resource by Health Professions Students

Incorporation of yoga in pharmacy education

BACKGROUND

The well-being of pharmacists is critical to support personal and professional health. Identifying and integrating a variety of practices that promote wellness is prudent for schools/colleges of pharmacy so students may form habits before entering the profession as practitioners. Yoga, a practice that combines muscular activity with mindfulness, can be incorporated with minimal resources via numerous mechanisms within and outside of the curriculum.

METHODS

The objective was to provide a summary of various strategies incorporating yoga in pharmacy professional curricula as well as detail various approaches to integrating yoga into pharmacy curricula. Literature was evaluated across professional pharmacy programs pertaining to yoga knowledge, beliefs, approaches, and benefits.

RESULTS

Ten articles about yoga awareness, knowledge, beliefs, and benefits in professional pharmacy curricula were identified. Improvement in mental health and decreased stress were recognized as benefits. Within schools/colleges of pharmacy, yoga programming has been included in required as well as elective courses, co-curriculum programming, extracurricular activities, and post-graduate training.

IMPLICATIONS

Schools of pharmacy can consider incorporation of yoga practice into curricula as a tool to promote well-being and resiliency.

Recommending yoga for health: A survey of perceptions among healthcare practitioners in the UK

BACKGROUND

Yoga has the potential to support patients across various health conditions. It is slowly being integrated into healthcare worldwide. While healthcare practitioners (HCPs) are critical to integration, there are currently no studies investigating their perceptions of yoga for health, their openness to recommending yoga to patients, and barriers to doing so. This novel UK study aims to address this.

METHOD

An online survey was conducted among practising UK HCPs. Recruitment was through multi-modal convenience sampling. The COM-B model was used as a framework. Regression analysis examined predictors of HCPs' likelihood to recommend yoga. Open-end responses were analysed through thematic analysis.

RESULTS

198 HCPs were included in the analysis, including general practitioners (GPs, 18.8%), psychologists (18.3%), and nurses/health visitors (14.7%). A high proportion (68.8%) practised yoga at least monthly. The likelihood of recommending yoga to patients was high (M = 4.03, SD = 0.94; 5-point scale). Older age, not being a GP, and greater capability and motivation significantly predicted a greater likelihood of recommending yoga, explaining 41.4% of the variance (p < 0.001). Barriers to recommending yoga were mostly related to the lack of opportunity.

CONCLUSIONS

HCPs in this study had high levels of personal engagement with yoga and were open to recommending yoga to patients, but still faced several barriers. Workplace support, particularly for GPs, and information about how patients can access appropriate and affordable yoga instruction would facilitate referral. Further research with a representative sample is warranted to understand perceptions of HCPs less engaged with yoga.

Quality of Life and Stress Management in Healthcare Professionals of a Dental Care Setting at a Teaching Hospital in Rome: Results of a Randomized Controlled Clinical Trial

In the healthcare environment, more and more people experience work-related stress. The Faculty of Medicine and Dentistry of Sapienza University of Rome, having observed the need to take care of healthcare professionals, has set itself the objective of providing useful tools such as additional and necessary personal protective equipment for healthcare professionals.

OBJECTIVE

To promote health through better management, skills, and the use of strategies and solutions to identify, decompress, and neutralize those responsible for work-related stress mechanisms in order to take care of those who care (CURARE CURANTES).

MATERIALS AND METHODS

A randomized controlled clinical trial was conducted. The participants were enrolled by three departments of the Department of Dental and Maxillofacial Sciences of Rome; in consideration of emotional involvement of health professionals who work there. A motivational program was offered.

RESULTS

There were 17 and 16 healthcare professionals in the intervention and control groups, respectively. Levels of the mental composite score (MCS) varied both in the pre-post phase of the intervention group (p = 0.002), and between the intervention group and control group in the post phase (p = 0.006). No significant differences were observed for the physical composite score (PCS). Similarly, there were no significant differences regarding the positivity scale (PS) and the two dimensions of work-related stress (job demand and decision latitude).

CONCLUSION

This study demonstrates the efficacy of yoga training practiced directly in the workplace and wearing work clothes, entering the work context, not weighing further on the healthcare workload, and being a way to carry out physical activity even in those cases in which professionals do not have the time to do it in their free time.

Yoga therapy knowledge in third-year pharmacy students: An education intervention

BACKGROUND AND PURPOSE

The omission of yoga education in health professions curricula limits health professionals from understanding how to support patient well-being in an integrated manner. The objective of this study was to examine the effectiveness of a yoga therapy-based educational intervention in increasing yoga knowledge of third-year pharmacy students.

EDUCATIONAL ACTIVITY AND SETTING

Students in the Pharmacognosy and Complementary and Alternative Medicine course received a three-hour educational intervention over two class meetings on yoga therapy during fall 2019. The pedagogical method of peer instruction was used, and pre- and post-questionnaires were administered online prior to and after the intervention. The instrument contained eight demographic, six yoga knowledge and participation, 10 yoga therapy, and 15 referral behavior questions.

FINDINGS

A statistically significant increase in yoga knowledge scores from 1.43 ± 0.9 before the education intervention to 5.69 ± 1.65 after the intervention occurred (P < .01) was found. A majority believed that yoga therapy should be included in the curriculum.

SUMMARY

Increases in post-questionnaire knowledge scores suggested that the educational intervention increased pharmacy students' knowledge of yoga therapy in our sample. Studies specific to yoga education in health professional students, especially in the United States, are scarce. Additionally, the impact of an educational intervention on yoga knowledge in pharmacy students has not been studied. Including yoga therapy in pharmacy curricula should be explored as greater integration of yoga in healthcare is likely to occur due to its effectiveness as an adjunct and widespread use.

Perceptions of benefits and barriers to Yoga practice across rural and urban India: Implications for workplace Yoga

BACKGROUND

Even though Yoga is useful for prevention of obesity, diabetes and hypertension it is not universally practiced. The purpose of the study was to determine the benefits and barriers confronted by the community members while incorporating Yoga into routine practice and at workplace.

OBJECTIVE

This study explored the motivators and barriers to Yoga practice by estimating how these elements can be useful for development and incorporation of Yoga as a workplace activity and as a profession.

METHODS

A nationwide multi-centered prospective study was conducted recruiting individuals of different age groups and geographical zones in India. Participants of Yoga intervention group were administered a questionnaire with 19 items on benefits (YBS) and 18 items on barriers for Yoga practice (BFYS). Data was analyzed using SPSS v21 software.

RESULTS

Majority of the participants perceived Yoga improves "physical fitness", "relaxes mind and body", improves "stamina", across age groups. "Lifestyle", "Family commitments", "Physical over-exertion", "No Encouragement from family", "Occupational commitments" and "Few places to do Yoga" were perceived barriers across various geographical zones. Despite knowing the benefits of Yoga, these barriers prevented individuals from integrating it into their daily routine.

CONCLUSIONS

The present study may be considered as a starting point for development of Yoga as a workplace activity and a profession based on the perceptions of its various benefits and barriers faced by a large study population spanning an entire nation.

Are screening by yoga instructors and their practice patterns important to prevent injuries in yoga clients?

BACKGROUND AND PURPOSE

Little information exists regarding the association of yoga-related injuries with yoga instructor (YI) practice patterns. Therefore, this cross-sectional survey examined the screening and practice characteristics of YI and its relationship with yoga-related injuries.

METHODS AND MATERIALS

YI from Northeastern US completed a customized web-based 57-item questionnaire.

RESULTS

The response rate of our questionnaire was 46%. In this study, only 8.8% of the YI reported physical performance screening and 33.7% of the participants did medical screenings with their clients. A binomial logistic regression analysis with the above variables revealed that adherence to training by YI (p = 0.031) and the use of Sun Salutations (p = 0.002) predicted lower yoga-related injuries in clients reported by YI.

CONCLUSIONS

Reduction in client yoga-related injuries was predicted by YI adhering to their training and performing Sun Salutations in their classes.

Massage perceptions and attitudes of undergraduate pre-professional health sciences students: a cross-sectional survey in one U.S. university

BACKGROUND

Attitudes and beliefs about massage therapy have been explored among health professionals and health profession students, but not for undergraduate preprofessional health sciences students.

METHODS

This cross-sectional survey sought to determine pre-professional health students' attitudes and perceptions toward massage therapy and determine the extent demographic variables such as age, gender, race, along with lifetime massage experience are associated with neutral/negative perceptions.

RESULTS

N = 129 undergraduate students completed the Attitudes Toward Massage scale and 7 supplemental items pertaining to sexuality and therapist gender preference along with questions regarding lifetime massage utilization. Prevalence of massage therapy utilization was 35.6% (lifetime) and 18.6% (last 12-months). Overall, positive attitudes towards massage therapy was observed with participants reporting massage experience expressing more positive massage attitudes (lifetime; p = 0.0081, the past 12 months; p = 0.0311). Participants with no massage experience were more likely to report neutral/negative attitudes toward massage (p = 0.04). Men were more likely to prefer their massage therapist to be of the opposite sex (38.9%) compared to women (2.1%) (p = < 0.0001). Men were less confident than women in their concern of becoming sexually aroused during massage (p = 0.0001) and in the belief that massage is sexually arousing (p = 0.048). Both genders expressed comfort with female and/or male massage therapists, but if given a choice, both prefer a female massage therapist.

CONCLUSIONS

Undergraduate pre-professional health sciences students have generally positive attitudes towards massage therapy however more research is needed regarding implicit gender bias and/or preferences. This work should inform future research designs examining the impact of attitudes and beliefs on patient referrals to massage therapy.

The Use of Yoga to Manage Stress and Burnout in Healthcare Workers: A Systematic Review

The purpose of this systematic review is to analyze and summarize the current knowledge regarding the use of yoga to manage and prevent stress and burnout in healthcare workers. In February 2017, a literature search was conducted using the databases Medline (PubMed) and Scopus. Studies that addressed this topic were included. Eleven articles met the inclusion criteria. Seven studies were clinical trials that analyzed yoga interventions and evaluated effectiveness by gauging stress levels, sleep quality and quality of life. A study on Chinese nurses showed statistical improvement in stress levels following a six-month yoga program (χ2 = 16.449; p < 0.001). A population of medical students showed improvement in self-regulation values after an 11-week yoga program (from 3.49 to 3.58; p = 0.04) and in self-compassion values (from 2.88 to 3.25; p = 0.04). Four of the included articles were observational studies: They described the factors that cause stress in the work environment and highlighted that healthcare workers believe it is possible to benefit from improved physical, emotional and mental health related to yoga activity. According to the literature, yoga appears to be effective in the management of stress in healthcare workers, but it is necessary to implement methodologically relevant studies to attribute significance to such evidence.

Yoga into Cancer Care: A Review of the Evidence-based Research

To cope with cancer and its treatment-related side effects and toxicities, people are increasingly using complementary and alternative medicine (CAM). Consequently, integrative oncology, which combines conventional therapies and evidence-based CAM practices, is an emerging discipline in cancer care. The use of yoga as a CAM is proving to be beneficial and increasingly gaining popularity. An electronic database search (PubMed), through December 15, 2016, revealed 138 relevant clinical trials (single-armed, nonrandomized, and randomized controlled trials) on the use of yoga in cancer patients. A total of 10,660 cancer patients from 20 countries were recruited in these studies. Regardless of some methodological deficiencies, most of the studies reported that yoga improved the physical and psychological symptoms, quality of life, and markers of immunity of the patients, providing a strong support for yoga's integration into conventional cancer care. This review article presents the published clinical research on the prevalence of yoga's use in cancer patients so that oncologists, researchers, and the patients are aware of the evidence supporting the use of this relatively safe modality in cancer care.

The North American yoga therapy workforce survey

OBJECTIVE

To describe the personal, professional, practice, service and consumer characteristics of the North American yoga therapy workforce.

DESIGN

Cross-sectional, descriptive survey developed and informed by the contemporary workforce literature. A link to the e-survey was distributed to members of the International Association of Yoga Therapists.

RESULTS

367 members responded (∼20% of eligible participants). Most were aged 40-69 years (88%) and female (91%). Almost half (42%) identified as a "seasoned yoga therapist" and few (9%) graduated from an accredited 800-h yoga therapy program. An average of 8h/week was spent in clinical practice with many (41%) earning an annual income of <US$10,000 from yoga therapy. Practice was informed by twenty different styles of yoga. Urban (39%) and suburban (38.1%) regions were the most common locations of practice. Most therapists conducted therapeutic yoga classes (91%) and 1:1 sessions (94%), with more than half delivering 1-10 therapeutic classes/month (53%) and 1-10 1:1 sessions/month (52%). Conditions seen most frequently were anxiety (77%), back/neck pain (77%) and joint pain/stiffness (67%).

CONCLUSION

While yoga therapists shared demographic characteristics with other complementary and integrative health (CIH) providers, they tended to work less and earn less than their CIH counterparts. Yoga therapists were less likely to work in rural settings, possibly contributing to the underutilization of yoga in underserved populations. Improving access to yoga therapy services, identifying common core components across the various styles of yoga, and building a stronger evidence-base for key health indications may increase acceptance of, and demand for, yoga therapy.

Yoga in Print Media: Missing the Heart of the Practice

Background:

Popular media typically portray yoga as an exercise or posture practice despite the reality that yoga comprised eight practices (called limbs) including ethical behavior, conscious lifestyle choices, postures, breathing, introspection, concentration, meditation, and wholeness.

Aim:

This study assessed the comprehensiveness of yoga practice as represented in articles in the popular yoga magazine, Yoga Journal. It explored the degree to which articles referenced each of the eight limbs of yoga and other contents (e.g., fitness, spirituality).

Materials and Methods:

Six coders were trained to reliably and independently review 702 articles in 33 Yoga Journal issues published between 2007 and 2014, coding for the limbs of yoga and other contents.

Results:

Breathing and postures were most frequently referenced, which were covered in 48.7% and 40.1% of articles. Internal practices were covered in 36.5% of articles with introspection being the most and concentration the least commonly referred to internal practices. Ethical and lifestyle practices were least frequently covered (5.2% and 6.8%). Since 2007, coverage of postures steadily increased, whereas contents related to the other limbs steadily decreased. The most frequent other contents related to fitness (31.7%), spirituality (20.8), and relationships (18.7%) coverage of these did not change across time.

Conclusions:

Representation of yoga in articles contained in the most popular yoga magazine is heavily biased in favor of physical practices. Recommendations are offered about how to shift media representation of yoga to make the heart of the practice more accessible to individuals who could experience health benefits but currently feel excluded from the practice.

Elements of yogic practice: Perceptions of students in healthcare programs

BACKGROUND

The practice of yoga has a long history as an integrated lifestyle science. Those who have practiced yoga in its full form (including all eight traditional aspects) find that it touches almost every aspect of their inter- and intra-personal lives. Despite this rich history, the West has adopted limited aspects of yoga practice. When understood narrowly as a physical fitness practice, healthful benefits of yoga may be lost, possibly promoting body-consciousness and injury instead.

AIM

To understand whether students in healthcare programs view yoga from a physical fitness versus holistic perspective, we explored perceptions of what constitute yoga's essential practices.

METHODS

We assessed endorsement of the eight limbs of yoga via the acceptability of yoga survey. The sample (n = 498) was recruited from programs in 10 healthcare professions at a Northwestern university. Participants were categorized as nonyogis, contemplators, yogis, and superyogis.

RESULTS

Across all groups, findings confirmed a narrow definition of yoga as portrayed in popular media and gym-based yoga classes. Breathing and posture practices were the most commonly endorsed practices, even among the sample's most seasoned yoga practitioners. Ethical practices and daily commitments of introspection, disciplined practice, or living with purity were least commonly associated with yoga despite their foundational nature in yoga philosophy. Concentration and meditation practices were only moderately endorsed as essential practices. Super-yogis endorsed a wider variety of limbs than nonyogis, contemplators, and yogis.

CONCLUSIONS

We offer a rationale for these findings along with recommendations that may help augment the definition of yoga and hence maximize its benefits.