Efficacy Of Meditation In The Management Of Anxiety
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Transcript of Efficacy Of Meditation In The Management Of Anxiety
Efficacy of Meditation in the Management of Anxiety Disorders
Danny Burr, RN, BSNUniversity of Central Florida
College of NursingNGR 6813
Anxiety Disorders
• Anxiety disorders are the most common mental illness in the U.S.
• affecting 40 million adults in the United States age 18 and older (18.1% of U.S. population)
Statistics. (2008, September 2). Retrieved September 23, 2008, from National Institute of Mental Health. Statistics and Facts About Anxiety Disorders. (2008).
Anxiety Disorders
• Generalized Anxiety Disorder (GAD)• Obsessive-Compulsive Disorder (OCD)• Panic Disorder• Posttraumatic Stress Disorder (PTSD)• Social Anxiety Disorder (SAD)• Specific Phobias
What Are the Symptoms of an Anxiety Disorder?
• Feelings of panic, fear and uneasiness• Uncontrollable, obsessive thoughts• Repeated thoughts or flashbacks of
traumatic experiences• Nightmares• Ritualistic behaviors, such as repeated hand
washing• Problems sleeping• Cold or sweaty hands and/or feet• Shortness of breath
Symptoms continue
• Palpitations• An inability to be still and calm• Dry mouth• Numbness or tingling in the hands or feet• Nausea• Muscle tension• Dizziness
PROBLEM
• Influence the health and relationships of family and friends
• Diminish ability to cope with coworkers, consequently, decreased productivity
• Anxiety disorders cost the U.S. more than $42 billion a year
• More than $22.84 billion of those costs are associated with the repeated use of health care services
Purpose & Question
• investigate the effectiveness of meditation in dealing with lowering of anxiety level of those whom suffered from anxiety
• can meditations effectively facilitate anxiety reduction, maintain physiological relaxation, and improved psychological outcomes on a consistent basis?
Relevance to Nursing
• Promote holistic health• Health promotion and disease prevention• Encourage non-pharmacologic therapy• sustain the quality of their disease
management
Databases and Search Terms
• CINAHL, MEDLINE, PsycInfo, Cochrane database of systematic reviews, and Cochrane central register of controlled trials
• Keywords included meditation, relaxation, mindfulness, treatment, adjunct, alternative therapy, anxiety disorders, generalized anxiety disorder, performance anxiety, and panic disorder
Inclusion & exclusion criteria
• Published between 1995 and 2008• Available in English• Come from peer review journals• Qualitative and Quantitative designs• Adult diagnosed with anxiety disorders• Studies with children were excluded• Studies of meditation that were not well
organized program or were not aimed to treat anxiety disorders sufferer were also excluded.
Coding
• Self-awareness and self-acceptancerecognized triggersfocus on the present moment
• Reducing severity and frequency of attackutilize meditation dailymany forms, can use in most settingsreduce endocrine stimulation
Coding (cont.)
• Improve quality of lifestop avoid going to places, social activities, and communicating with their spousesincreased ability to relaxdecreased inclination to assume negative conclusionsregain healthy relationship with family and friend
Validity of finding
• Problem and purpose are clearly stated• Research question is clearly defined• Methods clearly stated and appropriate• Outcomes measure relevance to efficacy of
meditation practice• Evidence provided was reliable and valid• Limitation of the studies are addressed
Validity of finding Rating System for the Hierarchy of Evidence* • Level I Evidence for a systematic review or
meta-analysis of all relevant RCTs or evidence-based clinical practice guidelines based on systematic reviews of RCTs.
• Level II Evidence obtained from at least one well-designed RCT.
• Level III Evidence obtained from one well-designed controlled trials without randomization.
Validity of finding• Level IV Evidence from well-designed case-
control and cohort studies. • Level V Evidence from systematic reviews of
descriptive or qualitative study. • Level VI Evidence from a single descriptive or
qualities study.• Level VII Evidence from the opinion of
authorities and/or reports of expert committees. Adapted from Melnyk, B. M., & Fineout - Overholt (2005).
Evidence based practice in nursing & healthcare. Philadelphia: Lippincott Willams.
Study Characteristics
• reviewed 11 research studies• 2 articles were systematic review or meta-
analysis • 5 articles were well-designed RCT. • 3 articles were well-designed controlled trials
without randomization. • 1 article was well-designed case-control and
cohort studies. • 1 article was systematic reviews of descriptive or
qualitative study.
Study limitations
• Small sample size• 10 out of 11 studies were not follow up• 5 out of 11 studies did not have control group
to compare the data• Some subjects were on pharmacotherapy
along with meditation training
Recommendations for Nursing
• Familiarize with s/s of anxiety disorders, 60% of patients seeking primary care are experiencing anxiety disorders
• Encourage to introduce mind/body health therapy to clients
• Cost efficient for clients• Clients potentially gain sustain benefits long term• Cultural beliefs/stigma/preferred non-
pharmacologic treatment
Conclusion
• Mindfulness meditation had established to be an effective prevention for an acute episode of anxiety and panic attack.
• Its benefits for long term management proved to be sufficient method in maintaining healthy understanding of self
• Enhance relations with friend and family
References• (Anxiety Disorders: Introduction 26)Anxiety Disorders: Introduction. (26). Retrieved October 19, 2008, from National Institute of
Mental Health Web Site: http://www.nimh.nih.gov/health/publications/anxiety-disorders/introduction.shtml• (Anxiety disorders 14)Anxiety Disorders. (14). Retrieved October 14, 2008, from American Psychiatric Association Web Site:
http://www.psych.org/MainMenu/Research/DSMIV/DSMIVTR/DSMIVvsDSMIVTR/SummaryofTextChangesInDSMIVTR/AnxietyDisorders.aspx
• Anxiety Disorders. (2008, April 2). Retrieved September 22, 2008, from National Institute of Mental Health: http://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml
• Arcangelo, V. P., & Peterson, A. M. (2006). Pharmacotherapeutics for advanced practice a practical approach. Philadelphia: Lippincott Wiliams & Wilkins.
• Arias, A., Steinberg, K., Banga, A., & Trestman, R. (2006). Systemic review of the efficacy of meditation techniques as treatment of medical illness. The Journal of Alternative and Complemetary Medicine, 12(8), 817-832.
• Buttaro, T. M., Trybulski, J., Bailey, P. P., & Sandberg - Cook, J. (2008). Primary care: a collaborative practice. St. Louis: Mosby.• Copstead, L.-E. C., & Banasik, J. L. (2000). Pathophysiology, biological and behavioral perspectives. Philadelphia: W.B. Saunders
Company.• Evans, S., Ferrando, S., Findler, M., Stowell, C., Smart, C., & Haglin, D. (2008). Mindfulness-based cognitive therapy for
generalized anxiety disorder. Journal of Anxiety Disorders , 22, 716-721.• Finucan, A., & Mercer, S. (2006). An exploratory mixed methods studyof the acceptability and effectiveness of mindfulness-
based cognitive therapy for patients with active depression and anxiety in primary care. BMC Psychiatry, 6(14),• Gill, S., Kolt, G. S., & Keating, J. (2004). Examining the multi-process theory: an investigation of the effects of two relaxation
techniques on state anxiety. Journal of Bodywork and Movement Therapies, 8, 2004. (Paul G Elam B Verhulst S J 2007 longtitudinal study of studens' perceptions of using deep breathing meditation to reduce testing stresses)
• Goolsby, M. J. (2002). Nurse practitioner secrets: questions and answers reveal the secrets to successful NP practice. Philadelphia: Haney & Belfus.
References• (Greenberg P E Sisitsky T Kessler R C Finkelstein S N Berndt E R Davidson J R 1999 economic burden
of anxiety disorders in the 1990's)Greenberg , P. E., Sisitsky, T., Kessler, R. C., Finkelstein, S. N., Berndt, E. R., & Davidson, J. R. (1999). The economic burden of anxiety disorders in the 1990's. Journal of Clinical Psychiatry, 60(7), 427-35.
• Grepmair, L., Mitterlehner, F., Loew, T., Bachler, E., Rother, W., & Nickel, M. (2007). Promoting mindfulness in psychotherapists in training influences the treatment results of their patients: a randomized, double-blind, controlled study. Psychotherapy and Psychosomatics, 76, 332-338. (Krisanaprakornkit T Krisanaprakornkit W Piyvhatkul N Laopaiboon M 2007 Meditation therapy for anxiety disorders (review))
• Koszychi, D., Benger, M., Shlik, J., & Bradwejn, J. (2007). Randomized trial of a meditation-based stress reduction program and cognitive behavior therapy in generalized social anxiety disorder. Behaviour Research and Therapy, 45, 2518-2526.
• Krisanaprakornkit, T., Krisanaprakornkit, W., Piyvhatkul, N., & Laopaiboon, M. (2007). Meditation therapy for anxiety disorders (review). The Cochrance Library, (4), 1-21. (Finucan A Mercer S 2006 An exploratory mixed methods studyof the acceptability and effectiveness of mindfulness-based cognitive therapy for patients with active depression and anxiety in primary care).
• Lee, S. H., Ahn, S. C., Lee, Y. J., Choi, T. K., Yook, K. H., & Suh, S. Y. (2007). Effectiveness of meditation-based stress management program as an adjunct to pharmacotherapy in patients with anxiety disorder. Journal of Psychosomatic Research , 62, 189-195.
• Lin, P., Chang, J., Vance, Z., & Midlarsky, E. (2008). Silent illumination: a study on Chan (Zen) meditation, anxiety, and musical performance quality. Psychology of Music, , 138-155.
References• McPhee, S. J., & Papadakis, M. A. (2008). Psychiatric Disorders. In S. Eisendrath & J. Lichtmacher
(Eds.), Current medical diagnosis & treatment (47th ed., pp. 897-902). New York: McGraw Hill. (Gill S Kolt G S Keating J 2004 Examining the multi-process theory: an investigation of the effects of two relaxation techniques on state anxiety)
• Melnyk, B. M., & Fineout - Overholt (2005). Evidence based practice in nursing & healthcare. Philadelphia: Lippincott Willams.
• Miller, J. J., Fletcher, K., & Kabat-Zinn, J. (1995). Three-year follow-up and clinical implications of a mindfulness meditation-based stress reduction intervention in the treatment of anxiety disorders. General Hospital Psychiatry, 17, 192-200. (Evans S Ferrando S Findler M Stowell C Haglin C 2008 Mindfulness-based cognitive therapy for generalized anxiety disorder)
• Paul, G., Elam, B., & Verhulst, S. J. (2007). A longtitudinal study of studens' perceptions of using deep breathing meditation to reduce testing stresses. Teaching and Learning in Medicine, 19(3), 287-292. (Lin P Chang J Vance Z Midlarsky E 2008 Silent illumination: a study on Chan (Zen) meditation, anxiety, and musical performance quality)
• Statistics. (2008, September 2). Retrieved September 23, 2008, from National Institute of Mental Health. Statistics and Facts About Anxiety Disorders. (2008). Retrieved September 23, 2008, from Anxiety Disorders Association of America: http://www.adaa.org/AboutADAA/PressRoom/Stats&Facts.asp
• Statistics and facts about anxiety disorders. (2008). Retrieved November 6, 2008, from Anxiety Disorders Association of America Web Site: http://www.adaa.org/AboutADAA/PressRoom/Stats&Facts.asphttp://