A journey through chaos and calmness: experiences of mindfulness training in patients with depressive symptoms after a recent coronary event - a qualitative diary content analysis

The efficacy of the 5E rehabilitation nursing model combined with mindfulness training on alleviating psychological distress and modulating coping styles in patients with acute myocardial infarction post-PCI: An observation study

To explore the influence of the 5E rehabilitation nursing model integrated with mindfulness training on mitigating psychological distress and adjusting coping styles in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). The clinical data of 94 patients with AMI who underwent PCI from August 2020 to January 2022 were retrospectively analyzed. Patients were divided into 2 groups based on different nursing modes. Among them, 47 cases received routine interventions were categorized into the control group, and 47 cases received the 5E rehabilitation nursing model integrated with mindfulness training on the basis of routine interventions were categorized into the study group. After 3 months of intervention, both groups exhibited a significant reduction in Self-Rating Anxiety Scale and Depression Scale scores compared to the pre-intervention period, with the study group demonstrating lower scores than the control group (P < .05). Herth Hope Index scores significantly improved in both groups after intervention, with the study group exhibiting higher scores than the control group (P < .05). After 3 months of interventions, Self-Care Agency scores significantly elevated in both groups, with the study group demonstrating higher scores than the control group (P < .05). WHO Quality of Life-BREF scores significantly improved in both groups, with the study group demonstrating higher scores than the control group (P < .05). The study group exhibited higher compliance and satisfaction levels and lower complication rate compared to the control group (P < .05). Integrating the 5E rehabilitation nursing model with mindfulness training effectively alleviates psychological distress, ameliorates quality of life, and improves satisfaction in AMI patients after PCI.

Pattern transitions in diary data of MDD patients: a mixed-methods multiple case study of psychotherapy dynamics

Aim

Mixed-methods approaches promise a deep understanding of psychotherapeutic processes. This study uses qualitative and quantitative data from daily diary entries and daily self-assessments during inpatient treatment. The aim of the study is to get an insight into the similarities and differences between both types of data and how they represent self-organized pattern transitions in psychotherapy. While a complete correlation of results is not expected, we anticipate observing amplifying and subsidiary patterns from both perspectives.

Materials and methods

Daily, five MDD patients wrote diaries and completed self-assessments using the Therapy Process Questionnaire, a questionnaire for monitoring the change dynamics of psychotherapy. The data were collected using the Synergetic Navigation System, an online tool for real-time monitoring. Diary entries of the patients described their experiences in everyday life. The qualitative text analysis was conducted using Mixed Grounded Theory, which provided categories representing the patients' ongoing experiences of transformation and stagnation. The time series data was analyzed using the dynamic complexity algorithm and the pattern transition detection algorithm. Results from qualitative and quantitative analyses were combined and compared. Following the process of data triangulation, the leading perspective came from the theory of self-organization. In addition to presenting the overall results for all five patients, we delve into two specific case examples in greater detail.

Results

Specific and highly diversified diary entries of 5 patients were classified into the categories of perceived pattern stability, noticing improvement, broadening the perspective, critical instability, and experiencing moments of Kairos. Patients reported problems not only related to their disorder (e.g., lack of energy and hopelessness) but also to phases and steps of change, which could be related to the theory of self-organization (e.g., problem attractors, critical fluctuations, pattern transitions, and Kairos). Qualitative and quantitative analysis provide important supplementary results without being redundant or identical.

Conclusion

Data triangulation allows for a comprehensive and multi-perspective understanding of therapeutic change dynamics. The different topics expressed in the diary entries especially help to follow micro-psychological processes, which are far from being a simple reaction to interventions. The way patients experience themselves being in stability or instability and stagnation or transformation is surprisingly close to the general features of self-organizing processes in complex systems.

Barriers and facilitators of engagement in psychological therapies among older adults with depression: A systematic review and thematic synthesis

WHAT IS KNOWN ON THE SUBJECT?: The utilization rate of psychological therapies is low in older adults with depression. The barriers and facilitators to engaging in psychological therapies experienced by older adults with depression are unclear. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: Personal suitability for therapy engagement, practical abilities, personal therapy preferences, and familiarity with psychological therapies are associated with psychological therapy engagement. Psychological therapists can also impact psychological therapy engagement among older adults with depression. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Proving the effectiveness and suitability of chosen psychological therapies is important for improving therapy engagement. Strategies for handling functional impairments among older adults with depression are necessary for engaging this population in psychological therapies. Although in-home psychological therapies are accessible, barriers to handling the technologies used for delivering the therapies should be addressed. More methods of accessing information about psychological therapies should be available to older adults in order for them to increase their knowledge on the topic. Psychological therapists should have positive attitudes and the competence to treat depression in older adults.

ABSTRACT

INTRODUCTION: Although psychological therapies are preferred by older adults, the utilization rate of these therapies is significantly low in older adults with depression. Understanding the barriers and facilitators to engaging in psychological therapies experienced by older adults is important for improving utilization rates.

AIM

This review aimed to explore the barriers and facilitators to engaging in psychological therapies experienced by older adults with depression.

METHODS

A systematic review of qualitative studies on psychological therapy engagement among older adults with depression. Relevant published studies and grey literature were searched. The Critical Appraisal Skills Programme tool was used to assess the quality of the included studies. The results of the included studies were synthesized using thematic synthesis.

RESULTS

Personal suitability for therapy engagement, practical abilities, personal therapy preferences and familiarity with psychological therapies was associated with therapy engagement. Therapists' competencies also affected therapy engagement.

DISCUSSION

Older adult's personal health status and requirements for psychological therapy should be considered.

IMPLICATIONS FOR PRACTICE

Mental health practitioners should consider whether specific psychological therapies are beneficial and acceptable for older adults. Improvements are needed in older adult's familiarity with psychological therapies and the ability of therapists to address the mental problems of older adults.

Mindfulness and Modified Medical Yoga as Intervention in Older Women with Osteoporotic Vertebral Fracture

Background: People with osteoporotic vertebral compression fractures (VCFs) have decreased health-related quality of life (HRQoL). Yoga and mindfulness are methods that can promote well-being. Objective: The aim of this article was to explore the effect of mindfulness and modified medical yoga on HRQoL, stress, sleep, and pain in people 60 years or older with a diagnosed osteoporotic VCF. Design: The School of Osteoporosis in Linköping (SOL) is a pilot study with randomized groups. Materials and Methods: The SOL-study was scheduled to once a week for 10 weeks. Ten people were randomized to a theory (T) group, and ten people were randomized to a theory and mindfulness/medical yoga (MMY) group. The educational sessions lasted 60 min and were similar for the groups, but they took place at different facilities. An experienced physiotherapist supervised the MMY sessions for 60 min. Sleep quality and present stress experience were measured on a symmetric Likert scale. The numeric rating scale was used for pain, and EQ-5D, RAND-36, and Qualeffo-41 were used for HRQoL. The patient enablement instrument (PEI) was used to reflect how the participants coped with their illness. Results: Eight women in the MMY-group and seven women in the T-group completed the SOL study interventions. The adherence to the intervention program was 89% in the MMY-group and 87% in the T-group. There was no adverse consequence of the MMY training. After the 10-week intervention period, sleep quality (p = 0.018) and present stress (p = 0.043), but not perceived pain were improved in the MMY-group. The social function (SF) domain was improved in the MMY-group that was measured by both RAND-36 (p = 0.028) and Qualeffo-41 (p = 0.012). There was a trend toward a better PEI-score in the MMY-group compared with the T-group postintervention (p = 0.089). Conclusion: This article suggests that mindfulness and modified medical yoga supervised by a skilled physiotherapist may be a feasible way to improve SF, sleep, and stress in older women with osteoporotic VCFs.

Priorities for Services in Young Patients With Atherosclerotic Cardiovascular Disease and Their Family Members: An Exploratory Mixed-Methods Study

Background

Optimal design of clinical programs for patients with premature atherosclerotic cardiovascular disease (ASCVD) (men aged ≤ 50 years, women aged ≤ 55 years) requires an understanding of their priorities. We aimed to explore patient and family priorities for services in clinical programs.

Methods

We co-designed this study with a Patient Partner Committee using a sequential exploratory mixed-methods design. In Phase I, we conducted semistructured interviews with participants from the Study to Avoid Cardiovascular Events in British Columbia (SAVE BC) (n = 15). In Phase II, we designed a questionnaire based on Phase I data and distributed it to all current SAVE BC participants. We collected close-ended responses (n = 116) and stratified data using participant category (index, family member), age, sex, and number of clinic visits.

Results

We identified 4 major priorities for services in clinical programs: social support (weight: 62.6%), patient education (weight: 83.5%), mental health (weight: 50.7%), and lifestyle changes (85.1%). To address these priorities, participants wanted ASCVD clinical programs to enable recruitment of their family members, establish a comprehensive education component (with research updates in research programs), deliver mental health screening and support after myocardial infarction, and provide longitudinal sessions to support maintenance of lifestyle modifications. These services were identified in Phase I and verified in Phase II.

Conclusion

We identified 4 priorities for services in clinical programs designed for patients with premature ASCVD and their families. Further research should be done to elucidate their outcomes and most effective methods to provide these services.

Case report: The use of medical yoga for adolescent mental health

Mental health issues are epidemic among youth in the United States today. Recent studies suggest that up to 50% of all teenagers have complaints related to stress, anxiety, and/or depression. This problem is accompanied by an unprecedented rise in the rates of child and teen suicide in the United States. In response to this epidemic, the American Academy of Pediatrics is recommending universal depression screening for all teens. Medications are available to ameliorate mental health disorders, and many can be safely used in the primary care setting. However, many of these medications have unwanted side effects or may not be familiar to the primary care physician. For these reasons and others, primary care physicians require additional approaches to respond to the challenges imposed by a growing number of patients requiring mental health support. Medical Yoga Therapy, prescribed by a physician with special yoga therapy training, offers a safe and effective way to serve the patient with physical or mental challenges disabilities. Medical Yoga therapy is an individualized and personal approach to the patient, and it may be integrated with any current therapy or medical regimen. Here, evidence for medical yoga is reviewed in the context of an adolescent patient with a common disorder. Yoga practices, with particular focus on mindfulness, offer a safe and effective intervention for a growing number of pediatric patients.