1,721,074 research outputs found
Dispositional predictors of placebo responding: a motivational interpretation of flower essence and gratitude therapy
No full textObjectivesThe aim of this study was to test a motivational interpretation of placebo responding using two different types of placebo therapy, one using flower essences and the other a nonspecific psychological therapy. The motivational concordance interpretation is that therapeutic rituals that are consistent with self-defining or self-actualizing goals have a nonspecific therapeutic benefit independently of expectancy.MethodsStudy 1 was a replication of an earlier flower essence outcome study but with additional outcome and predictor variables: 167 people completed questionnaires in return for free flower essence treatment. Predictor variables consisted of two measures of spirituality, optimism, expectancy, and attitudes and beliefs to complementary medicine. Outcome was assessed after 3 weeks. In Study 2, 90 people took part in “gratitude therapy” for improved sleep quality over one night in return for questionnaire completion (trait gratitude, spirituality, and expectancy).ResultsStudy 1 confirmed previous research: Trait spirituality predicted perceived improvement. This improvement was independent of optimism (P<.001), cannot be explained by acquiescence or social desirability, and was independent of a highly conservative test of expectancy (P=.02). In Study 2, trait gratitude predicted perceived sleep improvement independently of expectancy (P=.01): Spirituality did not correlate with improvement.ConclusionsThese data suggest that in addition to expectations, degree of engagement in a positive, therapeutic ritual determines the extent of the placebo response. The placebo response depends in part on the interaction (i.e., the degree of concordance) between the type of therapy and the participant's personality: Dispositional predictors vary with the type of placebo therapy.<br/
Emotional distress and well-being among people with motor neurone disease (MND) and their family caregivers: a qualitative interview study
No full textObjective: We aimed to get an in-depth understanding of the emotions experienced by people with motor neurone disease (MND) and their caregivers, and to explore what impacts emotional distress and well-being.Design: Qualitative study using semi-structured interviews with people with MND and caregivers.Setting: Participants were recruited from across the UK and took part in interviews conducted either face to face, by telephone or email to accommodate for varying levels of disability.Participants: 25 people with MND and 10 caregivers took part. Participants were purposively sampled based on their MND diagnosis, symptoms and time since diagnosis.Data analysis: Data were analysed using inductive reflexive thematic analysis.Results: Eight broad themes were generated (20 subthemes). Participants described the emotional distress of losing physical function and having a threatened future because of poor prognosis. Keeping up with constant changes in symptoms and feeling unsupported by the healthcare system added to emotional distress. Finding hope and positivity, exerting some control, being kinder to oneself and experiencing support from others were helpful strategies for emotional well-being.Conclusion: The study provides a broad understanding of what impacts emotional distress and well-being and discusses implications for psychological interventions for people with MND and caregivers. Any communication and support provided for people with MND and their caregivers, needs to pay attention to concepts of hope, control and compassion.<br/
Findings from the development of a novel course of both group and individual Alexander Technique lessons for neck, hip, and knee pain: a mixed methods study
No full textBackground: musculoskeletal pain, often affecting multiple sites — including neck, hip, and knee — is common, with limited treatment options. Novel treatments are needed to support self-management, preferably addressing multiple pain sites.Aim: To develop and explore the acceptability of a short, mixed course of individual (one-to-one) and group lessons in the Alexander Technique (AT), which addresses dysfunctional use of the musculoskeletal system.Design & setting: a single-centre, mixed-methods study of patients with chronic or recurrent neck, hip, or knee pain from four general practices.Method: preliminary development of a course of 10 AT lessons (six group, four individual) took place with a group of AT teachers. Semi-structured interviews of participants were undertaken, which were analysed using inductive thematic analysis. Descriptive pre-post analysis of quantitative scales were used to assess improvement (Numerical pain scale [NRS]; modified Roland–Morris Disability Questionnaire (RMDQ); enablement (modified Patient Enablement Instrument used in the ATEAMtrial); and global improvement (Health Transition scale).Results: twenty-three participants were included; 18 were interviewed. Commonly, participants found the mixture of group and individual lessons helpful, including helping multiple pain sites, and the mix of different problems enhanced learning. There was moderate improvement in standard quantitativemeasures over 12 weeks (NRS from 5.15 to 3.85; modified RMDQ 8.26 to 5.7) but with more substantial improvement in enablement and global improvement. Those who perceived underlying structural damage to the knee reported little benefit.Conclusion: people with chronic or recurrent neck, hip, or knee pain found a course of mixed group and individual lessons in AT helpful in managing their pain, but not those with severe knee problems. Whether standard quantitative measures provide the best measures of effectiveness requires exploration
Predictors of adherence to home-based physical rehabilitation therapies: a systematic review
No full textPurpose: Self-managed, home-based physical therapy (HBPT) is an increasingly common element of physical therapy rehabilitation programmes but non-adherence can reach 70%. Understanding factors that influence patients’ adherence to HBPTs could help practitioners support better adherence. Research to date has focussed largely on clinic-based physiotherapy. The objective of this review, therefore, was to identify specific factors, which influence adherence to home-based, self-managed physical therapies.Method: A systematic review was conducted, in which eight online databases were searched using combinations of key terms relating to physical therapies, adherence and predictors. Matching records were screened against eligibility criteria and 30 quantitative articles were quality assessed and included in the final review. Relevant data were extracted and a narrative synthesis approach was taken to aggregating findings across studies.Results: There was relatively strong evidence that the following factors predicted adherence to HBPTs: intention to engage in the HBPT, self-motivation, self-efficacy, previous adherence to exercise-related behaviours and social support.Conclusions: This review has identified a range of factors that appear to be related to patients’ adherence to their self-managed physical rehabilitation therapies. Awareness of these factors may inform design of interventions to improve adherence
Dataset for the Southampton doctoral thesis 'Developing and evaluating a digital mental health intervention for MND'
No full textThis dataset contains 3 separate datasets of interview transcripts conducted for the PhD thesis 'Development and evaluation of a digital mental health intervention for people with Motor Neurone Disease and their caregivers'</span
Findings from the development and implementation of a novel course consisting of both group and individual Alexander Technique lessons for low back pain
No full textObjectives: to develop a mixed course of individual and group lessons in the Alexander Technique (AT) for low back pain, and (2) to explore its: (a) effectiveness and (b) acceptability to both participant AT teachers and patients.Design: single-centre study, mixed methods.Setting: members of the public in the Brighton area (community recruitment), and patients from six Hampshire General Practices (GP) (National Health Service (NHS) recruitment).Participants: people with chronic or recurrent low back pain; AT teachers.Interventions: iterative development and implementation of a 10-lesson (6 group, 4 individual) AT course.Outcome measures: perceptions from semistructured interviews analysed using inductive thematic analysis. Descriptive analysis of RMDQ (Roland-Morris Disability Questionnaire) over 12 weeks.Results: thirty-nine participants with low back pain were included and 32 AT teachers were interviewed, 7 of whom taught on the course. Some participants had reservations, preferring only individual lessons, but the majority found the sharing of experience and learning in groups helpful. There was also concern regarding group teaching among some AT teachers, but most also found it acceptable. By 12 weeks, RMDQ score among participants fell from 10.38 to 4.39, a change of −5.99. 29 of 39 (74%) participants had a clinically important reduction in RMDQ score of 2.5 or more.Conclusion: some patients and practitioners had reservations about group AT lessons, but most found groups helpful. Further development is needed, but the course of individual and group lessons has the potential to cost-effectively deliver clinically important benefits to patients with back pain, who are known to improve little and slowl
Dissociating the facets of hope: agency and pathways predict dropout from unguided self-help therapy in opposite directions
No full textHope comprises two components: agency (“goal directed determination”) and pathways (“planning of ways to meet goals”). We tested whether these two components can be dissociated and therefore differentially predict dropout from two unguided self-help interventions to reduce worry (gratitude vs. thought monitoring and cognitive restructuring interventions, N = 247 entered, 136 completed). The two hope components significantly predicted attrition in opposite directions; agency predicted completion (OR = 2.15, CI = 1.27–3.64, p = .004), whereas pathways predicted dropout (OR = .47, CI = .29–.77, p = .003). Gratitude and thought monitoring reduced worry compared a wait list control, and for completers there was no difference in outcome. Conclusion: hope facets can be dissociated; gratitude techniques are as effective and have better retention than a technique commonly used in cognitive behavior therapy
Managing antidepressant discontinuation: a systematic review
Full text linkPurposeTo determine the effectiveness of interventions to manage antidepressant discontinuation, and outcomes for patients.MethodsSystematic review with narrative synthesis and meta-analysis. Sources: MEDLINE, PubMed, Embase, PsycINFO, AMED, Health Management Information Consortium (HMIC), OpenGrey, and WHO International Clinical Trials Registry Platform (ICTRP) to March 2017. Including: randomised controlled trials (RCTs), quasi-experimental, and observational studies assessing interventions to facilitate discontinuation of antidepressants for depression in adults. Primary outcomes: antidepressant discontinuation, and discontinuation symptoms. Secondary outcomes: relapse/ recurrence, quality of life, antidepressant reduction, sexual, social, and occupational function.ResultsOf 15 studies included, 12 were in the synthesis (8 RCTs, 2 single-arm trials, 2 retrospective cohort studies). None of the studies was rated high risk for selection or detection bias. Two studies prompting primary care provider (PCP) discontinuation with antidepressant tapering guidance found 6% and 7% of patients discontinued, versus 8% for usual care. Six studies of psychological or psychiatric treatment plus tapering reported cessation rates of between 40% and 95%. Two studies reported a higher risk of discontinuation symptoms with abrupt termination. At 2 years, risk of relapse/ recurrence was lower with cognitive behaviour therapy (CBT) plus taper versus clinicalmanagement plus taper (15%-25% vs 35%-80%: RR 0.34, 95% CI 0.18 to 0.67; 2 studies).Relapse/recurrence rates were similar for mindfulness based cognitive therapy (MBCT) with tapering and maintenance antidepressants (44%-48% vs 47%-60%; 2 studies).ConclusionsCBT or MBCT can help patients discontinue antidepressants without increasing the risks of relapse/recurrence, but are resource intensive. More scalable interventions are needed, incorporating psychological support
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