Outcomes of a Multimodal Resilience Training Program in an Outpatient Integrative Medicine Clinic

The interactivity and independence of Recovery challenges and coping strategies for ICU survivors and their caregivers: a systematic review and Meta-synthesis

BACKGROUND

The post-ICU home recovery period requires patients and caregivers to confront recovery challenges and adopt coping strategies as a family dyad, necessitating effective dyadic interaction patterns. Existing qualitative research shows that the dyads face interactive or independent challenges and employs varying coping strategies, which may include strong communication or, conversely, avoidance. However, a single qualitative study alone might offer limited generalizability, and there is a lack of broader, more nuanced understanding about the recovery challenge and copings among ICU survivors and caregivers. This meta-synthesis aims to figure out the interactivity and independence of challenges and coping strategies during the recovery process for ICU survivors and caregivers.

METHODS

This is a meta-synthesis of qualitative studies, which was guided by the Stress and Coping Framework. We systematically reviewed six electronic databases, including PubMed, Medline, the Cochrane Library, CINAHL, PsycArticles, and PsycInfo, for relevant qualitative studies published from inception to January, 2024. We utilized a content analysis approach for data analysis. Presentation of this synthesis adhered to the PRISMA guideline and the ENTREQ guideline.

RESULTS

After full-text screening, 49 studies were included. Four themes with 16 sub-themes emerged from this synthesis including, interactivity of recovery challenges for ICU survivors and caregivers (subthemes: Life was turned upside down, Situational overstrain, Isolation without compassion, Empowerment conflicts, Marginalized support), independence of recovery challenges for ICU survivors and caregivers (subthemes: Recovery means silent suffering, Gap in memory, Sacrificing to caregiving), interactivity of recovery coping strategies for ICU survivors and caregivers (subthemes: Reorientation of mindset, Cultivating inner power, Sharing burden with an open-ear, Going through thick and thin together, Negotiating care level), and independence of recovery coping strategies for ICU survivors and caregivers (subthemes: Wearing a faked smile, Developing daily routine, Seeking respite).

CONCLUSIONS

The findings suggest that ICU survivors and caregivers experience overlapping yet distinct challenges during recovery, often involving shared coping strategies, alongside a need for individual space. These results support the presence of both interactivity and independence in recovery challenges and coping strategies for ICU survivors and their caregivers. Therefore, we call for future dyadic or family interventions to target both ICU survivors and caregivers, taking advantage of their interactivity and desire for gradual independence, so that fostered individualized coping strategies adapted to flexible contexts.

Psychological interventions for enhancing resilience in parents of children with cancer: a systematic review and meta-analysis

PURPOSE

Caring for children with cancer is considerably stressful for parents and may negatively affect their physical and psychological well-being. Resilience plays a pivotal role in maintaining psychological well-being in the face of stress and adversity. The aim of this systematic review was to evaluate the effectiveness of psychological interventions in promoting resilience among parents of children with cancer.

METHODS

Five English databases and two Chinese databases were subjected to a systematic search from inception to March 2020. The methodological quality of the included randomised controlled trials was evaluated using the Cochrane risk of bias tool (RoB 2.0). Meta-analyses and descriptive analyses were used. Subgroup analyses of the intervention modes and time since diagnosis were also conducted.

RESULTS

Five studies involving 308 participants were included. The systematic review identified three types of psychological intervention, namely resilience training, self-disclosure and peer support, which had different essential components and characteristics. The meta-analyses of three randomised controlled trials revealed that the psychological interventions enhanced parents' resilience with a large effect size (Hedges' adjusted g 0.92; 95% CI 0.22, 1.62; p = .01).

CONCLUSION

Evidence supports the effectiveness of psychological interventions for enhancing resilience in the parents of children with cancer. Healthcare professionals can incorporate evidence-based psychological interventions to enhance resilience to help these parents better navigate adversity, adapt to their children's situations and improve their psychological well-being.

Traumatic Distress of COVID-19 and Depression in the General Population: Exploring the Role of Resilience, Anxiety, and Hope

International evidence published so far shows that the COVID-19 pandemic has negatively impacted on global mental health. Specifically, there is some research suggesting that the psychological distress related to depression, anxiety and posttraumatic stress has impacted on the psychological well-being of the general population. Yet, there is limited evidence on the relational paths between COVID-19 traumatic distress and depression. Participants of this cross-sectional study were 456 adults 18 years old or older from the general population (Mean age = 41.2 years, SD = 11.7) who completed an online questionnaire including measures assessing depression, anxiety, resilience, hope and traumatic distress related to COVID-19. Structural equation modelling was applied to examine the proposed mediation model. The results confirmed the proposed model, with traumatic distress of COVID-19, resilience, anxiety and hope explaining a considerable amount of variance (59%) in depression scores. Traumatic distress of COVID-19 was a strong positive predictor of depression, while anxiety, hope and resilience were both joint and unique mediators of this relationship. Exposure to the COVID-19 pandemic is strongly associated with depression in adults of the general population. The co-occurrence of anxiety may negatively contribute to experiencing higher levels of depression, while resilience and hope may act as buffers against depression associated with the impact of this pandemic. Our findings suggest that wide community-based interventions designed to promote resilience, build hope and reduce anxiety may help mitigate depression associated with exposure to the COVID-19 pandemic.

The Feasibility and Efficacy of a Brief Integrative Treatment for Adults With Depression and/or Anxiety: A Randomized Controlled Trial

The aim of this study was to investigate the efficacy and suitability of a brief integrative intervention, Personalized Integrative Therapy (PI Therapy), for the treatment of adult depression and/or anxiety. In this 6-week, 3-arm, parallel-group, randomized trial, PI Therapy delivered alone or with nutritional supplements (PI Therapy + Supps) was compared to cognitive behavior therapy (CBT) in 48 adults with depression and/or anxiety. All treatments were delivered as a 1-day workshop plus 6 weeks of reminder phone text messages to reinforce topics and skills covered in the workshop. Affective symptoms decreased significantly and to the same extent in all 3 conditions. At the end of treatment, 33% to 58% of participants reported levels of depressive symptoms in the normal range, and 50% to 58% reported nonclinical levels of anxiety. Compared to CBT and PI Therapy, PI Therapy + Supps was associated with significantly greater improvements in sleep quality. These findings suggest that a brief integrative intervention with or without supplements was comparable to CBT in reducing affective symptoms in adults with depression and/or anxiety. However, sleep quality improved only in the PI Therapy + Supps condition. These findings will require replication with a larger cohort.

Integrative medicine in anxiety disorders

Anxiety disorders are a current public health issue, as an estimated 16.5% of the Portuguese population suffers from this condition. The goal of this descriptive study was to analyze the efficiency of the treatment of integrative medicine (acupuncture and therapeutic massage) to reduce anxiety disorders and to describe the sociodemographic characteristics of Integrative Medicine Institute (IMI) patients. To this end, a documental analysis from the data base of the clinical reports of IMI was performed, with the approval of the Ethics Committee of the Health Sciences Research Unit with informed consents being signed by all patients. Between January and August 2017, 259 IMI patients were treated. Of these, 30,5% had been diagnosed with an anxiety disorder. Ten sessions of Integrative Medicine (IM) using acupuncture techniques combined with therapeutic massage were applied. Each session consisted of an initial treatment of acupuncture for 30 min, followed by a therapeutic massage for another 30 min. Before starting all 10 treatments, anxiety levels were measured by a self-perception 5 points scale. Anxiety levels were also assessed at the end of the 5th and the 10th treatment. It was found that 75.29% of the patients looking for IM were female and 34.4% were professionals working in intellectual and scientific activities. Patients taking anxiolytic medication presented higher levels of anxiety in comparison with non-medicated ones (p = 0.000). After a maximum of ten treatments (acupuncture combined with massage), the levels of anxiety were reduced (98.39% after five sessions). Women at their tenth treatment reached lower anxiety levels than those of men. The therapies used are proved to be efficient and can be used as a complementary care to treat and relief the symptoms of anxiety disorders. This research is the basis for designing a future randomized control trial study of acupuncture efficiency in the treatment of anxiety disorders.

The Effects of an Online Mind-Body Training Program on Stress, Coping Strategies, Emotional Intelligence, Resilience and Psychological State

The goal of this study was to evaluate the effects of an online mind-body training (MBT) program on participants’ stress, anger, coping strategies, emotional intelligence, resilience, and positive and negative affect. Forty-two healthy women participated in an online MBT program for approximately 8–10 minutes a day for 8 weeks; a control group of 45 healthy women did not participate in the program. Self-report psychological questionnaires were administered before the beginning of the program and at 4 and 8 weeks following its onset. Data from the MBT group and the control group were compared using repeated measures ANOVA and Student’s t-tests. Significant time x group interaction effects were found with respect to stress, coping strategies, anger, emotional intelligence, negative affect and resilience. These results demonstrate beneficial effects of the online MBT program and significant improvements in the psychological capabilities of participants compared with the control group. The effects of online MBT program were similar with those of the previous offline MBT in psychological aspects, suggesting further studies for neuroscientific evidence related stress and emotion of online MBT effects.