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Efficacy Of Meditation In The Management Of Anxiety
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Efficacy Of Meditation In The Management Of Anxiety

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    Efficacy Of Meditation In The Management Of Anxiety Efficacy Of Meditation In The Management Of Anxiety Presentation Transcript

    • Efficacy of Meditation in the Management of Anxiety Disorders Danny Burr, RN, BSN University of Central Florida College of Nursing NGR 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-acceptance
      • recognized triggers
      • focus on the present moment
      • Reducing severity and frequency of attack
      • utilize meditation daily
      • many forms, can use in most settings
      • reduce endocrine stimulation
    • Coding (cont.)
      • Improve quality of life
      • stop avoid going to places, social activities, and communicating with their spouses
      • increased ability to relax
      • decreased inclination to assume negative conclusions
      • regain 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://