Positive functioning as an outcome in its own right.
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976 to 1000 of 6,178DeWalt DA, Schillinger D, Ruo B, Bibbins-Domingo K, Baker DW, Holmes GM, Weinberger M, Macabasco-O'Connell A, Broucksou K, Hawk V, Grady KL, Erman B, Sueta CA, Chang PP, Cene CW, Wu JR, Jones CD, Pignone M (2012)randomised controlled trialMEDLINE-indexed journal, not yet read by usCirculation85 citations Multisite randomized trial of a single-session versus multisession literacy-sensitive self-care intervention for patients with heart failure.
Background: Self-care training can reduce hospitalization for heart failure (HF), and more intensive intervention may benefit more vulnerable patients, including those with low literacy.
Methods and results: A 1-year, multisite, randomized, controlled comparative effectiveness trial with 605 patients with HF was conducted. Those randomized to a single session received a 40-minute in-person, literacy-sensitive training; the multisession group received the same initial training and then ongoing telephone-based support. The primary outcome was combined incidence of all-cause hospitalization or death; secondary outcomes included HF-related hospitalization and HF-related quality of life, with prespecified stratification by literacy. Overall, the incidence of all-cause hospitalization and death did not differ between intervention groups (incidence rate ratio, 1.01; 95% confidence interval, 0.8…
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Effects of a program to prevent social isolation on loneliness, depression, and subjective well-being of older adults: a randomized trial among older migrants in Japan.
Social isolation among the elderly is a concern in developed countries. Using a randomized trial, this study examined the effect of a social isolation prevention program on loneliness, depression, and subjective well-being of the elderly in Japan. Among the elderly people who relocated to suburban Tokyo, 63 who responded to a pre-test were randomized and assessed 1 and 6 months after the program. Four sessions of a group-based program were designed to prevent social isolation by improving community knowledge and networking with other participants and community "gatekeepers." The Life Satisfaction Index A (LSI-A), Geriatric Depression Scale (GDS), Ando-Osada-Kodama (AOK) loneliness scale, social support, and other variables were used as outcomes of this study. A linear mixed model was used to compare 20 of the 21 people in the intervention group to 40 of the 42 in the control group, and s…
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Therapeutic mechanisms of a mindfulness-based treatment for IBS: effects on visceral sensitivity, catastrophizing, and affective processing of pain sensations.
Irritable bowel syndrome (IBS) is a prevalent functional disorder characterized by abdominal pain and hypervigilance to gastrointestinal sensations. We hypothesized that mindfulness training (MT), which promotes nonreactive awareness of emotional and sensory experience, may target underlying mechanisms of IBS including affective pain processing and catastrophic appraisals of gastrointestinal sensations. Seventy five female IBS patients were randomly assigned to participate in either 8 weeks of MT or a social support group. A theoretically grounded, multivariate path model tested therapeutic mediators of the effect of MT on IBS severity and quality of life. Results suggest that MT exerts significant therapeutic effects on IBS symptoms by promoting nonreactivity to gut-focused anxiety and catastrophic appraisals of the significance of abdominal sensations coupled with a refocusing of atten…
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Dyads affected by chronic heart failure: a randomized study evaluating effects of education and psychosocial support to patients with heart failure and their partners.
Background: Chronic heart failure (CHF) causes great suffering for both patients and their partners. The aim of this study was to evaluate the effects of an integrated dyad care program with education and psychosocial support to patients with CHF and their partners during a postdischarge period after acute deterioration of CHF.
Methods: One hundred fifty-five patient-caregiver dyads were randomized to usual care (n = 71) or a psychoeducation intervention (n = 84) delivered in 3 modules through nurse-led face-to-face counseling, computer-based education, and other written teaching materials to assist dyads to develop problem-solving skills. Follow-up assessments were completed after 3 and 12 months to assess perceived control, perceived health, depressive symptoms, self-care, and caregiver burden.
Results: Baseline sociodemographic and clinical characteristics of dyads in the experimental…
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Long-term functional outcome in adult prison inmates with ADHD receiving OROS-methylphenidate.
In a recent randomized, double-blind, placebo-controlled trial, we established a robust efficacy (Cohen's d = 2.17) of osmotic release oral system-methylphenidate (OROS-methylphenidate) delivered 72 mg daily for 5 weeks versus placebo on attention deficit hyperactivity disorder (ADHD) symptoms, global severity and global functioning in 30 adult male prison inmates with ADHD and coexisting disorders. Outcomes continued to improve during the subsequent 47-week open-label extension with OROS-methylphenidate delivered at a flexible daily dosage of up to 1.3 mg/kg body weight. In the present study, we evaluated long-term effectiveness and maintenance of improvement over the cumulated 52-week trial on cognition, motor activity, institutional behaviour and quality of life. Post hoc, we explored the associations between investigators' and self-ratings of ADHD symptoms and between ratings of symp…
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Hesser H, Gustafsson T, Lundén C, Henrikson O, Fattahi K, Johnsson E, Zetterqvist Westin V, Carlbring P, Mäki-Torkko E, Kaldo V, Andersson G (2012)randomised controlled trialMEDLINE-indexed journal, not yet read by usJournal of consulting and clinical psychology152 citations A randomized controlled trial of Internet-delivered cognitive behavior therapy and acceptance and commitment therapy in the treatment of tinnitus.
Objective: Our aim in this randomized controlled trial was to investigate the effects on global tinnitus severity of 2 Internet-delivered psychological treatments, acceptance and commitment therapy (ACT) and cognitive behavior therapy (CBT), in guided self-help format.
Method: Ninety-nine participants (mean age = 48.5 years; 43% female) who were significantly distressed by tinnitus were recruited from the community. Participants were randomly assigned to CBT (n = 32), ACT (n = 35), or a control condition (monitored Internet discussion forum; n = 32), and they were assessed with standardized self-report measures (Tinnitus Handicap Inventory; Hospital Anxiety and Depression Scale; Quality of Life Inventory; Perceived Stress Scale; Tinnitus Acceptance Questionnaire) at pre-, posttreatment (8 weeks), and 1-year follow-up.
Results: Mixed-effects linear regression analysis of all randomized pa…
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Long-term quality-of-life outcomes after radical prostatectomy or watchful waiting: the Scandinavian Prostate Cancer Group-4 randomised trial.
Background: For men with localised prostate cancer, surgery provides a survival benefit compared with watchful waiting. Treatments are associated with morbidity. Results for functional outcome and quality of life are rarely reported beyond 10 years and are lacking from randomised settings. We report results for quality of life for men in the Scandinavian Prostate Cancer Group Study Number 4 (SPCG-4) after a median follow-up of more than 12 years.
Methods: All living Swedish and Finnish men (400 of 695) randomly assigned to radical prostatectomy or watchful waiting in SPCG-4 from 1989 to 1999 were included in our analysis. An additional 281 men were included in a population-based control group matched for region and age. Physical symptoms, symptom-induced stress, and self-assessed quality of life were evaluated with a study-specific questionnaire. Longitudinal data were available for 166 …
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Walton GM, Cohen GL (2011)randomised controlled trialMEDLINE-indexed journal, not yet read by usScience (New York, N.Y.)426 citations A brief social-belonging intervention improves academic and health outcomes of minority students.
A brief intervention aimed at buttressing college freshmen's sense of social belonging in school was tested in a randomized controlled trial (N = 92), and its academic and health-related consequences over 3 years are reported. The intervention aimed to lessen psychological perceptions of threat on campus by framing social adversity as common and transient. It used subtle attitude-change strategies to lead participants to self-generate the intervention message. The intervention was expected to be particularly beneficial to African-American students (N = 49), a stereotyped and socially marginalized group in academics, and less so to European-American students (N = 43). Consistent with these expectations, over the 3-year observation period the intervention raised African Americans' grade-point average (GPA) relative to multiple control groups and halved the minority achievement gap. This pe…
matched on Happiness (mesh), well-being (text)
Short-term cognitive behavioral therapy for non-cardiac chest pain and benign palpitations: a randomized controlled trial.
Objectives: Many patients with noncardiac chest pain or benign palpitations have poor prognosis in terms of symptom persistence, limitations in everyday activities, and reduced health-related quality of life (HRQOL). The aim of the study was to compare a three-session manualized cognitive behavioral therapy (CBT) intervention with normal care for patients with noncardiac chest pain or benign palpitations in a randomized controlled trial.
Methods: Patients with persistent complaints six months after a negative evaluation at a cardiological outpatient clinic were invited to participate. Of the 94 eligible patients, 40 agreed to participate and were randomly assigned to either an intervention or control group. Patients in the intervention group received three manualized sessions with CBT, including one physical activity exposure session. The control group received usual care from their gene…
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Long-term follow-up of internet-delivered exposure and mindfulness based treatment for irritable bowel syndrome.
We conducted a follow-up of a previously reported study of internet-delivered cognitive behavior therapy (CBT) for IBS, based on exposure and mindfulness exercises (Ljótsson et al. (2010). Internet-delivered exposure and mindfulness based therapy for irritable bowel syndrome - a randomized controlled trial. Behaviour Research and Therapy, 48, 531-539). Seventy-five participants from the original sample of 85 (88%) reported follow-up data at 15-18 months (mean 16.4 months) after completing treatment. The follow-up sample included participants from both the original study's treatment group and waiting list after it had been crossed over to treatment. Intention-to-treat analysis showed that treatment gains were maintained on all outcome measures, including IBS symptoms, quality of life, and anxiety related to gastrointestinal symptoms, with mainly large effect sizes (within-group Cohen's d=…
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Physical conditioning and mental stress reduction--a randomised trial in patients undergoing cardiac surgery.
Background: Preoperative anxiety and physical unfitness have been shown to have adverse effects on recovery from cardiac surgery. This study involving cardiac surgery patients was primarily aimed at assessing the feasibility of delivering physical conditioning and stress reduction programs within the public hospital setting. Secondary aims were to evaluate the effect of these programs on quality of life (QOL), rates of postoperative atrial fibrillation (AF) and length of stay (LOS) in hospital.
Methods: Elective patients scheduled for coronary artery bypass graft and/or valve surgery at a public hospital in Melbourne, Australia were enrolled. Patients were randomized to receive either holistic therapy (HT) or usual care (UC). HT consisted of a series of light physical exercise sessions together with a mental stress reduction program administered in an outpatient setting for the first two…
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Kravitz RL, Tancredi DJ, Grennan T, Kalauokalani D, Street RL, Slee CK, Wun T, Oliver JW, Lorig K, Franks P (2011)randomised controlled trialMEDLINE-indexed journal, not yet read by usPain54 citations Cancer Health Empowerment for Living without Pain (Ca-HELP): effects of a tailored education and coaching intervention on pain and impairment.
We aimed to determine the effectiveness of a lay-administered tailored education and coaching (TEC) intervention (aimed at reducing pain misconceptions and enhancing self-efficacy for communicating with physicians) on cancer pain severity, pain-related impairment, and quality of life. Cancer patients with baseline "worst pain" of ≥4 on a 0-10 scale or at least moderate functional impairment due to pain were randomly assigned to TEC or enhanced usual care (EUC) during a telephone interview conducted in advance of a planned oncology office visit (265 patients randomized to TEC or EUC; 258 completed at least one follow-up). Patients completed questionnaires before and after the visit and were interviewed by telephone at 2, 6, and 12 weeks. Mixed effects regressions were used to evaluate the intervention adjusting for patient, practice, and site characteristics. Compared to EUC, TEC was asso…
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Internet-based treatment of depression: a randomized controlled trial comparing guided with unguided self-help.
Internet-delivered self-help for depression with therapist guidance has shown efficacy in several trials. Results from meta-analyses suggest that guidance is important and that self-help programs without support are less effective. However, there are no direct experimental comparisons between guided and unguided internet-based treatments for depression. The present study compared the benefits of a 10-week web-based unguided self-help treatment with the same intervention complemented with weekly therapist support via e-mail. A waiting-list control group was also included. Seventy-six individuals meeting the diagnostic criteria of major depression or dysthymia were randomly assigned to one of the three conditions. The Beck Depression Inventory (BDI-II) was used as the primary outcome measure. Secondary outcomes included general psychopathology, interpersonal problems, and quality of life. …
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Porter LS, Keefe FJ, Garst J, Baucom DH, McBride CM, McKee DC, Sutton L, Carson K, Knowles V, Rumble M, Scipio C (2011)randomised controlled trialMEDLINE-indexed journal, not yet read by usJournal of pain and symptom management119 citations Caregiver-assisted coping skills training for lung cancer: results of a randomized clinical trial.
Context: Lung cancer is one of the most common cancers in the United States and is associated with high levels of symptoms, including pain, fatigue, shortness of breath, and psychological distress. Caregivers and patients are adversely affected. However, previous studies of coping skills training (CST) interventions have not been tested in patients with lung cancer nor have systematically included caregivers.
Objectives: This study tested the efficacy of a caregiver-assisted CST protocol in a sample of patients with lung cancer.
Methods: Two hundred thirty-three lung cancer patients and their caregivers were randomly assigned to receive 14 telephone-based sessions of either caregiver-assisted CST or education/support involving the caregiver. Patients completed measures assessing pain, psychological distress, quality of life (QOL), and self-efficacy for symptom management; caregivers comp…
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Complementary use of tai chi chih augments escitalopram treatment of geriatric depression: a randomized controlled trial.
Background: Nearly two-thirds of elderly patients treated for depression fail to achieve symptomatic remission and functional recovery with first-line pharmacotherapy. In this study, we ask whether a mind-body exercise, Tai Chi Chih (TCC), added to escitalopram will augment the treatment of geriatric depression designed to achieve symptomatic remission and improvements in health functioning and cognitive performance.
Methods: : One hundred twelve older adults with major depression age 60 years and older were recruited and treated with escitalopram for approximately 4 weeks. Seventy-three partial responders to escitalopram continued to receive escitalopram daily and were randomly assigned to 10 weeks of adjunct use of either 1) TCC for 2 hours per week or 2) health education (HE) for 2 hours per week. All participants underwent evaluations of depression, anxiety, resilience, health-relate…
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Stress Management and Resilience Training (SMART) program to decrease stress and enhance resilience among breast cancer survivors: a pilot randomized clinical trial.
Unlabelled: This randomized controlled trial assessed the effect of a SMART (Stress Management and Resiliency Training) program among 25 women diagnosed with breast cancer. Resilience, perceived stress, anxiety, and quality of life improved at 12 weeks in the active but not the control arm. A brief training in the SMART program can enhance resilience and quality of life and decrease stress and anxiety.
Introduction: Patients with breast cancer experience stress and anxiety related to their diagnosis, with resulting lower quality of life. The purpose of this study was to assess the effect of a SMART (Stress Management and Resiliency Training) program for increasing resiliency and for decreasing stress and anxiety among mentors who themselves were previously diagnosed with breast cancer.
Materials and methods: The program consisted of two 90-minute group training sessions, a brief individu…
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Effects of a home-based walking intervention on mobility and quality of life in people with diabetes and peripheral arterial disease: a randomized controlled trial.
Objective: Determine the efficacy of a home-based walking intervention to improve walking ability and quality of life in people with diabetes and peripheral arterial disease (PAD).
Research design and methods: We conducted a randomized, controlled, single-blind trial within university-affiliated clinics in our local community. We randomized 145 participants (45 women) with diabetes and PAD to our intervention--a 6-month behavioral intervention targeting levels of readiness to engage in routine walking for exercise--versus attention control. Our primary outcome was 6-month change in maximal treadmill walking distance. Secondary outcomes included 3-month change in maximal walking distance, lower limb function (i.e., walking impairment scores), quality of life (Medical Outcomes Short Form Survey), exercise behaviors, depressive symptoms, and self-efficacy at 3 and 6 months.
Results: The mea…
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The effects of expressive writing following first myocardial infarction: a randomized controlled trial.
Objective: To assess the effects of expressive writing on health care utilization, clinical variables and subjective quality of life following first myocardial infarction (MI).
Methods: One-hundred and seventy-nine first MI patients were randomized to Intervention (N = 88) or Control (N = 91) groups. The intervention group wrote about their thoughts and feelings in relation to having had an MI. Controls wrote in a neutral way about daily activities. The main outcome measures were health care utilization, physical status and subjective quality of life (QOL), assessed after one, two, and five months.
Results: One-hundred and fifty-six (87%) completed the study. Five months post-intervention, the intervention group had significantly fewer recorded medical appointments compared to controls. The number of prescribed medicines decreased over time within the intervention group but increased wit…
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Effect of essential amino acid supplementation on quality of life, amino acid profile and strength in institutionalized elderly patients.
Background & aims: This study assessed the efficacy of supplemented essential amino acids on depressive symptoms, nutrition, muscle function, daily physical activity, and health-related quality of life (HRQoL) of institutionalized elderly patients.
Methods: Forty-one patients (58.5% women; mean age 79.8 yrs) with sequelae of coronary artery disease (73%), femoral fracture (34%), were randomly assigned to receive oral essential amino acids 4 gr 2 times a day for 8 weeks or isocaloric placebo. Before randomization and 8 weeks after the protocol started, the following variables were measured: depressive symptoms (Geriatric Depression Scale, GDS), nutritional panel (Mini Nutritional Assessment, MNA; serum albumin and prealbumin levels), muscle strength (Hand Grip, HG), Activity Daily Life (ADL), Quality of Life (SF-36, HRQoL) and amino acid profile.
Results: Compared with the placebo group, …
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Viola LF, Nunes PV, Yassuda MS, Aprahamian I, Santos FS, Santos GD, Brum PS, Borges SM, Oliveira AM, Chaves GF, Ciasca EC, Ferreira RC, Paula VJ, Takeda OH, Mirandez RM, Watari R, Falcao DV, Cachioni M, Forlenza OV (2011)randomised controlled trialMEDLINE-indexed journal, not yet read by usClinics (Sao Paulo, Brazil)53 citations Effects of a multidisciplinary cognitive rehabilitation program for patients with mild Alzheimer's disease.
Objective: To evaluate the effects of a multidisciplinary rehabilitation program on cognition, quality of life, and neuropsychiatry symptoms in patients with mild Alzheimer's disease.
Method: The present study was a single-blind, controlled study that was conducted at a university-based day-hospital memory facility. The study included 25 Alzheimer's patients and their caregivers and involved a 12-week stimulation and psychoeducational program. The comparison group consisted of 16 Alzheimer's patients in waiting lists for future intervention.
Intervention: Group sessions were provided by a multiprofessional team and included memory training, computer-assisted cognitive stimulation, expressive activities (painting, verbal expression, writing), physiotherapy, and physical training. Treatment was administered twice a week during 6.5-h gatherings.
Measurements: The assessment battery comprise…
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The WRITTEN-HEART study (expressive writing for heart healing): rationale and design of a randomized controlled clinical trial of expressive writing in coronary patients referred to residential cardiac rehabilitation.
Background: Coronary heart disease (CHD) is typically associated with many cardiovascular risk factors (e.g., elevated blood pressure), low health-related quality of life, depression, anxiety and psychological stress. Expressive writing (EW) has shown beneficial effects on such variables in both people from the community and in patients with a variety of chronic illnesses. However, no study to date has evaluated the physical and psychological effects of the expressive writing procedure on coronary patients referred to cardiac rehabilitation (CR).
Methods: The clinical effectiveness of a 2-week disease-related expressive writing procedure (writing about one's deepest thoughts and feelings regarding the experience with heart disease) compared with the standard writing task (writing about one's deepest thoughts and feelings about the most traumatic or negative event experienced in the life)…
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The effectiveness of yoga for the improvement of well-being and resilience to stress in the workplace.
Objectives: Recent research has indicated concern for the degree of stress and emotional well-being among university staff. This study examined the effectiveness of yoga in enhancing emotional well-being and resilience to stress among university employees.
Methods: In a randomized controlled trial at a British university, we recruited 48 employees and randomized them into either a yoga or a wait-list control group. The yoga group was offered six weeks of Dru Yoga, comprising one 60-minute class per week. These classes were offered by a certified Dru Yoga instructor at lunchtime from January-March 2008. The wait-list control group received no intervention during this six-week study. Baseline and end-program measurements of self-reported mood and well-being were self-assessed with the Profile of Mood States - Bipolar (POMS-Bi) and the Inventory of Positive Psychological Attitudes (IPPA).
R…
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Hopko DR, Armento ME, Robertson SM, Ryba MM, Carvalho JP, Colman LK, Mullane C, Gawrysiak M, Bell JL, McNulty JK, Lejuez CW, Lejuez CW (2011)randomised controlled trialMEDLINE-indexed journal, not yet read by usJournal of consulting and clinical psychology120 citations Brief behavioral activation and problem-solving therapy for depressed breast cancer patients: randomized trial.
Objective: Major depression is the most common psychiatric disorder among breast cancer patients and is associated with substantial impairment. Although some research has explored the utility of psychotherapy with breast cancer patients, only 2 small trials have investigated the potential benefits of behavior therapy among patients with well-diagnosed depression.
Method: In a primarily Caucasian, well-educated sample of women (age = 55.4 years, SD = 11.9) diagnosed with breast cancer and major depression (n = 80), this study was a randomized clinical trial testing the efficacy of 8 sessions of behavioral activation treatment for depression (BATD) compared to problem-solving therapy. Primary outcome measures assessed depression, environmental reward, anxiety, quality of life, social support, and medical outcomes.
Results: Across both treatments, results revealed strong treatment integrity…
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Influence of regular exercise on subjective sense of burden and physical symptoms in community-dwelling caregivers of dementia patients: a randomized controlled trial.
With an aim to improve quality of life in caregivers of dementia patients, we examined the effect of regular exercise on caregivers' sense of burden and their physical symptoms. Participants were 31 elderly caregivers living with older patients diagnosed with Alzheimer's-type dementia. They were randomly assigned to either the intervention group, who were prescribed regular exercise with moderate-intensity: 3 metabolic equivalents (3METs), 3 times per week for 12 weeks, or the control group, who did not receive any prescription. In the intervention group, significant reductions in the Zarit caregiver burden interview (ZBI) score and in the frequency of feeling fatigued, and an improvement in quality of sleep were observed at follow-up (p < 0.05), while no such changes were observed in the control group. These results suggest that obtaining sustainable habit of moderate exercise may impro…
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Changes in the Body Image and Relationship Scale following a one-year strength training trial for breast cancer survivors with or at risk for lymphedema.
Unlabelled: The aim of this study was to evaluate the impact of a twice-weekly strength training intervention on perceptions of body image in 234 breast cancer survivors (112 with lymphedema) who participated in the Physical Activity and Lymphedema (PAL) trial. The study population included two hundred and thirty-four women randomly assigned to twice-weekly strength training or control group that completed the 32-item Body Image and Relationships Scale (BIRS) at baseline and 12 months. Percent change in baseline to 12-month BIRS total and subscale scores, upper and lower body strength, and general quality of life (QOL) were compared by intervention status. A series of multiple linear regression models including indicator variables for subgroups based on age, marital status, race, education, BMI, and strength change were used to examine differential intervention impact by subgroup. Streng…
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