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Background and objectives Up to 50% of patients undergoing hemodialysis suffer from symptoms of depression and/or anxiety. Access to traditional pharmacotherapies and psychotherapies for depression or anxiety in this patient population has been inadequate. The objective of this study was to investigate the feasibility and effectiveness of brief mindfulness meditation intervention for patients on hemodialysis with depression and anxiety symptoms.Design, setting, participants, & measurements This study was a randomized, controlled, assessor-blinded trial conducted in an urban hemodialysis unit. Forty-one patients were randomly assigned to intervention (n=21) and treatment-as-usual (n=20) groups. The intervention group received an 8-week individual chairside meditation intervention lasting 10–15 minutes, three times a week during hemodialysis. Feasibility outcomes were primarily assessed: enrollment rates, intervention completion rates, and intervention tolerability. Symptoms of depression and anxiety were measured using the Patient Health Questionnaire (PHQ-9) and the General Anxiety Disorder-7 (GAD-7).
Results Of those deemed eligible for the study, 67% enrolled (41 of 61). Of the participants randomized to the intervention group, 71% completed the study, with meditation being well tolerated (median rating of 8 of 10 in a Likert scale; interquartile range=10–5 of 10). Barriers to intervention delivery included frequent hemodialysis shift changes, interruptions by staff or alarms, space constraints, fluctuating participant medical status, and participant fatigue. Meditation was associated with subjective benefits but no statistically significant effect on depression scores (change in PHQ-9, −3.0±3.9 in the intervention group versus −2.0±4.7 in controls; P=0.45) or anxiety scores (change in GAD-7, −0.9±4.6 versus −0.8±4.8; P=0.91).
Conclusions On the basis of the results of this study, mindfulness meditation appears to be feasible and well tolerated in patients on hemodialysis with anxiety and depression symptoms. The study did not reveal significant effects of the interventions on depression and anxiety scores.
BACKGROUND AND OBJECTIVES:Up to 50% of patients undergoing hemodialysis suffer from symptoms of depression and/or anxiety. Access to traditional pharmacotherapies and psychotherapies for depression or anxiety in this patient population has been inadequate. The objective of this study was to investigate the feasibility and effectiveness of brief mindfulness meditation intervention for patients on hemodialysis with depression and anxiety symptoms.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS:
This study was a randomized, controlled, assessor-blinded trial conducted in an urban hemodialysis unit. Forty-one patients were randomly assigned to intervention (n=21) and treatment-as-usual (n=20) groups. The intervention group received an 8-week individual chairside meditation intervention lasting 10-15 minutes, three times a week during hemodialysis. Feasibility outcomes were primarily assessed: enrollment rates, intervention completion rates, and intervention tolerability. Symptoms of depression and anxiety were measured using the Patient Health Questionnaire (PHQ-9) and the General Anxiety Disorder-7 (GAD-7).
RESULTS:
Of those deemed eligible for the study, 67% enrolled (41 of 61). Of the participants randomized to the intervention group, 71% completed the study, with meditation being well tolerated (median rating of 8 of 10 in a Likert scale; interquartile range=10-5 of 10). Barriers to intervention delivery included frequent hemodialysis shift changes, interruptions by staff or alarms, space constraints, fluctuating participant medical status, and participant fatigue. Meditation was associated with subjective benefits but no statistically significant effect on depression scores (change in PHQ-9, -3.0±3.9 in the intervention group versus -2.0±4.7 in controls; P=0.45) or anxiety scores (change in GAD-7, -0.9±4.6 versus -0.8±4.8; P=0.91).
CONCLUSIONS:
On the basis of the results of this study, mindfulness meditation appears to be feasible and well tolerated in patients on hemodialysis with anxiety and depression symptoms. The study did not reveal significant effects of the interventions on depression and anxiety scores.
Information overload is one of the factors behind current alarming statistics on stress. Meditation helps the body-mind resist the deleterious effects of the information on-slaught. Though meditation is well known as a relaxation technique, its noetic value is often overlooked. Its benefits extend well beyond superficial soothing: it trains attention; it increases pattern recognition; and it reconnects us to the whole of our intelligence, enhancing coordination between its complementary poles. Meditation is a potent high-touch resource in a high-tech world.
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"The first comprehensive overview of holistic education's history, conceptions, practices, and research, this Handbook provides an up-to-date picture of the field as it currently exists around the globe. Specifically, it examines the field's theoretical and historical foundations; offers examples of holistic education in practice with regard to schools, programs, and pedagogies; presents research methods used in holistic education; outlines new and emerging research in the field; and examines potential areas for future program development and research. This volume is a must-have resource for researchers and practitioners and an essential foundational text for courses in the field"--
The flow construct has recently been proposed as essential to understanding consumer navigation behavior in online environments. We review definitions and models of flow, and describe an empirical study which measures flow in terms of respondents’ skills and challenges for using the World Wide Web. Skills and challenges are shown to correlate in anticipated ways with scales measuring constructs of flow, control, arousal, and anxiety that underlie previous models of flow. By taking the sum and difference of skills and challenges as axes of a two dimensional space, we derive a simple conceptualization of flow. The sum and difference of skills and challenges for using the Web relates in hypothesized ways to measures of consumer search and purchase behavior in online and traditional media.
Yogic high-frequency respiration--kapalabhati (KB)--was studied in 24 subjects from a point of rhythmicity. Respiratory movements, blood pressure and R-R intervals of ECG were recorded in parallel and evaluated by spectral analysis of time series. Respiratory signals during KB were modulated by 0.1 Hz rhythm in 82% of experiments. This component was also present in R-R intervals and blood pressure during KB. Frequency (0.2-0.3 Hz) was observed in 67% of respiratory records. The presence of the component 0.2-0.3 Hz in respiration was dependent on resting respiratory frequency. This frequency component was reduced in R-R intervals but increased in blood pressure during kapalabhati as compared to that at rest. The occurrence of both frequency components in respiration during KB supports the hypothesis about the integrative role of cardiovascular and respiratory rhythms in physiological states characterized by altered respiratory frequency.