THE EFFECT OF PROGRESSIVE MUSCLE RELAXATION TRAINING ON ANXIETY LEVELS AND QUALITY OF LIFE IN DIALYSIS PATIENTS

AIM

To determine the effect of progressive muscle relaxation training (PMRT) on anxiety levels and quality of life (QoL) in dialysis patients.

METHODS

A total of 46 patients who had been treated with dialysis in the Dialysis Center of Ege University Medical Faculty Hospital were recruited. Data were collected by means of a questionnaire. Patients' Recognition Form (PRF), State and Trait Anxiety Inventory (STAI), and QoL-index for dialysis patients (QoLI-dialysis) were used to collect the necessary data. All three forms were utilised prior to PMRT and 6 weeks after completion of PMRT.

RESULTS

The mean state-anxiety score before and after PMRT was found as 43.4 +/- 4.3 and 28.9 +/- 2.8, respectively (P<0.001). Similarly, the mean trait-anxiety scores before and after PMRT were found as 43.6 +/- 9.5 and 31.1 +/- 6.5, respectively (P<0.001). When the QoLI-dialysis score was examined it was 28.7 +/- 3.2 before PMRT and 29.6 +/- 2.3 after PMRT (P<0.01).

CONCLUSION

The results of the study demonstrate that PMRT for dialysis patients helps decrease state- and trait-anxiety levels and has a positive impact on QoL.

Effect of team training on patients' ability to complete MRI examinations

RATIONALE AND OBJECTIVES

Assess whether staff training in advanced rapport skills and self-hypnotic relaxation techniques reduces noncompletion rates during magnetic resonance imaging (MRI).

METHODS AND MATERIALS

All staff of a free-standing MRI facility was invited to 3 hours of preparatory communication lectures. Half of the practice was then engaged in intensive training. Clerical personnel and nonlicensed health care professionals received training in advanced rapport skills only (8 hours); licensed health care professionals were trained in advanced rapport skills plus rapid hypnotic techniques (17 hours). Content was adapted so that no interruptions of workflow would become necessary. The format included lectures, large group discussions, small group practice, and a microteaching exercise.

RESULTS

During the quarter of operation before the training 1.2% (80 of 6,654) of patients could not complete their studies. After training, 0.74% (52 of 7,008) patients did not complete their scans (P < .01). Noncompletion rates of scans on the open magnet, on which the most anxious patients were scheduled, decreased from 3.43% (37 of 1,078 patients per quarter) to 1.45% (19 of 1,098). After staff was informed that the MRI partnership would be dissolved and personnel might be transferred or laid off, the noncompletion rate increased again, although not to the original levels; then, after partial dismantling of the facility, leveled off to 0.92% overall and 1.84% on the open magnet. Success was maintained at 1-year follow-up.

CONCLUSION

Team training in advanced rapport skills and self-hypnotic relaxation techniques significantly reduces MRI noncompletion rates. Personnel distress can adversely affect the patient experience.

Providing emotional stability through relaxation training

To determine the effects of integrative relaxation training (IRT) on emotional stability, we exposed 32 patients diagnosed with anxiety disorder to a pre-test (16PF) and to 12 sessions of group psychoeducation training. Patients were randomly assigned to 2 groups (study 17 and control 15 patients). The study group received 12 weekly group sessions of IRT. Level of anxiety was evaluated in a post-test using a questionnaire and the State-Trait Anxiety Inventory (STAI). Emotional stability and level of anxiety were significantly reduced in the study group: there was a marked increase in scores for emotionally s and venturesome and a decrease in scores for apprehensive and tense. The STAI score was statistically significantly lower in the study group.

Stress reduction for nurses through Arts-in-Medicine at the University of New Mexico Hospitals

Artists-in-medicine at the University of New Mexico help nurses remember and renew the values that originally attracted them to the field of nursing. Exploring their nascent creativity through massage, yoga, art, music, and writing, nurses are encouraged to reconnect emotionally and spiritually with themselves, their patients, and fellow healthcare workers.

A pilot study of distraction for adolescents during allergy testing

PURPOSE

This pilot study describes pain and anxiety associated with allergy testing; tests distraction, specifically self-selected distraction; and examines the relationship between pain, anxiety, and engagement with distraction.

DESIGN AND METHODS

An experimental design was used with a convenience sample of 32 adolescents from an allergist's office randomly assigned to three groups. Pain was measured by the adolescent pediatric pain tool (APPT) and FACES scale.

RESULTS

No differences in pain ratings were found among the groups. Less pain was associated with lower anxiety and greater engagement with distraction. Greater engagement with distraction occurred with less anxiety.

PRACTICE IMPLICATIONS

Knowledge about allergy testing pain, anxiety, and engagement with distraction can assist nurses in preparing adolescents for this procedure.

Psychological approaches for the nursing management of chronic pain: part 2

AIMS AND OBJECTIVES

The aim of this article was to present the ways that nurses can integrate psychological approaches into their management of chronic pain conditions using a biopsychosocial framework. Communication, the importance of the patient-practitioner interaction, the role of education and provision of information, reassurance and reduction of anxiety and the use of coping strategies training in the management of chronic pain are reviewed alongside the key skills of nursing.

BACKGROUND

This is the second part of a two-part article. Part 1 was a discussion of psychosocial factors associated with chronic pain conditions and the psychological approaches used in the management of these conditions.

CONCLUSIONS

It is identified that key nursing skills often equate to the requirements of the psychological approaches, therefore specific techniques from a cognitive-behavioural framework can be readily applied, integrated and used by nurses in the management of chronic pain conditions.

RELEVANCE TO CLINICAL PRACTICE

Commonly utilized nursing skills are similar to those required for cognitive-behavioural therapy. It is reasonable to assume therefore that nurses can and should be involved in effectively managing the psychological aspects associated with chronic pain conditions.

Stress management for African American women with elevated blood pressure: a pilot study

This article reports the results of a pilot study testing the effects of two stress management interventions on blood pressure (BP) and stress-related variables in employed African American women. Thirty-three women with mean age 44.8 +/- 7.6 years were randomly assigned to a cognitive mediation group (n=10), a relaxation group (n=12), or a delayed treatment control group (n=11). The participants in the two stress management groups participated in a 10-week intervention; the delayed treatment control group received BP monitoring during the 10-week period. Measures included BP, the State-Trait Anger Expression Inventory, Personal Strain, and Coping Resources. Although no significant Group x Time effects were found in BP, anger, or personal strain, several of the outcome measures appear to be sensitive and showed cell means in the hypothesized direction. Further study of the effects of stress management interventions on BP and stress, with a larger sample, is warranted.

Telecare for women with postpartum depression

Data were collected to pilot test the feasibility and effects of telecare as an intervention for depression in a small group of mothers with postpartum depression. Treatment involved a 10-week telecare therapy consisting of three related aspects: cognitive-behavioral therapy, relaxation techniques, and problem-solving strategies. Beck Depression Inventory II scores were significantly lower after telecare treatment. Women identified psycho-education as the greatest help to them.

Needle phobia--changing venepuncture practice in ambulatory care

Needle phobia is a term used in practice to describe an anticipatory fear of needle insertion. A proportion of children display high levels of fear, pain and behavioural distress when exposed to, or anticipating, needle insertion. A difficult routine venepuncture in our ambulatory care unit led staff to review practice and develop a three-step approach to overcoming 'needle phobia': relaxation, control and graded exposure. These developments have resulted in the unit becoming a local referral centre for children and young people between the ages of 5-19 years with this problem. Time and skill are needed to prevent or overcome this distressing problem which can be caused by health care professionals not listening to children and young people.

The short-term effects of a body awareness program: better self-management of health problems for individuals with chronic a-specific psychosomatic symptoms

A three-day residential Body Awareness Program (BAP) was developed to teach people with Chronic A-specific Psychosomatic Symptoms (CAPS) to react adequately to disturbances of the balance between a daily workload and the capacity to deal with it. The short-term effects of the program for people with CAPS are presented in this study. The design is a non-control group design with pre- and post-measures (2 months after the program). The sample for this paper was formed by 187 participants. The mean age is 42.3 (S.D. = 8.9), and 57% is female. The results showed decreased stress-related symptoms, increased quality of life, increased self-efficacy, less depressive attribution style, more expression of emotions, and a positive change of lifestyle. Most of these measured changes can be interpreted as clinically relevant outcomes with medium-to-large effect sizes. Personal pre-training goals were attained by 85% of the participants. Spouses also confirmed the found effects. Evaluation of the BAP gives enough evidence to conclude that this program leads to positive effects in CAPS. Participants react more adequately to disturbances between daily workload and the capacity to deal with this load. They are more capable of self-management in coping with stress and psychosomatic symptoms. Conclusions are drawn about the prevention by early interventions for patients with a-specific physical symptoms.

The implementation of snoezelen in psychogeriatric care: an evaluation through the eyes of caregivers

Many intervention studies lack an investigation of the extent to which the intervention was implemented as intended, which makes outcome measures difficult to interpret. The aim of the present study was to gain insight into the implementation process of snoezelen in 24-h dementia care. The intervention in each of six experimental wards comprised training sessions in 'snoezelen for caregivers', evaluated using a questionnaire. To study experience with implementation, the follow-up and general meetings (20 in total) were attended and semi-structured interviews (six in total) were conducted. The results indicated that the implementation of snoezelen effected a change from task-oriented care to resident-oriented care. The nursing assistants also experienced changes at the resident level and organisational changes. However, the lack of intervention in the organisational structure and obstructive factors such as under-staffing seemed to get in the way of the integration of multi-sensory stimulation in the daily care in two of the six wards.