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Anxiety is a common mental health disorder that affects many Americans yet often goes unrecognized or undertreated. The purpose of this article is to review the current literature to assist in determining which alternative and complimentary therapy, aerobic exercise or yoga, is most beneficial in reducing anxiety symptoms. The literature search process resulted in a total of 14 articles included in the review. Results indicate that yoga is more effective in decreasing anxiety symptoms than aerobic exercise. Health care providers can use this information to help recommend an alternative form of therapy for patients.

Very little is known about the use of nutritional supplements in children with Tourette syndrome. The current study aimed to address the frequency of nutritional supplements and the use of special diets in children with Tourette syndrome and typically developing children. Additional data also sought to address the motivations behind using them, their cost and perceived benefits. A total of 76 responses from an anonymous online survey (Tourette syndrome = 42; typically developing = 34) were completed and analyzed. Fifty-six per cent of children with Tourette syndrome compared to 15% of typically developing children were currently taking nutritional supplements, with the majority take two or more. Thirty-five per cent of the Tourette syndrome compared to 6% typically developing were currently or had previously adopted a special diet. Supplements most used for children with TS included probiotics, omega-3, multivitamins and magnesium. For children with TS, supplementation often began around the age of eight, for a duration on average of 35 months. The average cost was £32.44 a month compared to £8.25 for typically developing children. Seventy-five per cent of supplement users in the Tourette syndrome group noted improvement, mainly in motor and vocal tics, sleep quality and anxiety reduction. Most caregivers learned of supplements through the Internet. In almost 42% of the Tourette syndrome group, their pediatrician was unaware of the supplement use and this rose to 65% for special diets. Given the popularity of nutritional supplements, more research on the effectiveness and safety of such interventions is crucial.

Background: Anxiety in pre-operative patients affects the success of lasik action and can cause problems such as psychosis and personality disorders. Non-pharmacological interventions that can overcome anxiety are juice drinks. Objective: Knowing the difference in the level of anxiety before and after drinking lettuce juice in patients with pre surgery at the Jogja Lasik Center Eye Hospital "Dr. YAP” Yogyakarta. Method: This type of research is a quasi-experimental with a pretest and posttest approach. The population in this study were all preoperative patients. The sampling technique used total sampling, the number of samples was 16 people, the data analysis used the independent t-test. Result: Results obtained an average difference in anxiety reduction after juice administration of 106.81. There was a difference in anxiety levels in pre-operative patients after being given Juice. Conclusion: Therapy is more effective compared to the juice against the anxiety level of pre-surgery patients at Jogja Lasik Center Rs Mata "Dr. YAP" Yogyakarta.

Patients admitted to Critical Care Units (CCU) face multiple stressors, and these stressors cause anxiety in patients. Anxiety increases heart function in heart patients. High levels of anxiety in cardiac patients increase in association with hospital complications. The purpose of this study was to determine the effect of Cognitive-Behavioral Therapy (CBT) on reducing the anxiety of patients in CCU during their hospitalization. The study design was quasi-experimental (pre-test and post-test). This study was performed on patients in CCU of Shahid Mostafa Khomeini hospital in 2019; for this purpose, 30 patients in CCU were randomly divided into intervention (n=15) and control (n=15) groups. Before the intervention, the demographic variables questionnaire and DASS-21 anxiety questionnaire were completed by both groups. Then, the intervention group received CBT for eight sessions according to the average number of hospital days (eight days) by the therapist (researcher). The control group did not receive any intervention. After the intervention, the demographic variables questionnaire and DASS-21 questionnaire were completed by the intervention and control groups again. Data analysis was done by SPSS-21 software and descriptive tests, ANOVA, and independent and pairwise t-test. There was no significant difference between the two groups in the mean score of anxiety before treatment, but the mean score of anxiety significantly decreased after treatment in the intervention group (9.63±2.773) compared to the control group (13.23±2.115; p

The purpose of this study was to explore the use of immersive and interactive virtual reality (VR) for analgesia, anxiety reduction, and overall satisfaction in patients undergoing outpatient postoperative debridements.Randomized crossover-controlled trial.Academic outpatient clinic.Adult patients who had functional endoscopic sinus surgery and skull base surgery and were undergoing office-based postoperative nasal endoscopy and debridement were recruited and followed for 2 consecutive office visits. Participants were randomized to receive either the control or experimental analgesia for the first postoperative visit (PO1) and crossed over into the opposite treatment arm during the second postoperative visit (PO2). Outcomes included procedural pain, anxiety and satisfaction scores, procedural time, and reflexive head movements per minute (RHM).Eighty-two participants were recruited. At PO1, 39 received standard analgesia, and 43 received an immersive VR experience. At PO1, the VR group experienced significantly less anxiety (VR technology holds promise as a nonpharmacologic analgesic and anxiolytic intervention for otolaryngology office-based procedures. Further study of VR use in other procedures is warranted.1, randomized controlled trial.

Introduction Anxiety is one of the most commonly diagnosed mental health disorders on post-secondary campuses, often brought on by stressors unique to the college environment. Traditional psychological approaches to manage anxiety might focus on breathing techniques and progressive muscle relaxation. However, additional techniques that use specific sensory input to reduce anxiety have not received the same attention in the literature. Method This longitudinal study compared four interventions for state anxiety (deep breathing, progressive muscle relaxation, an adapted dive reflex, and use of a weighted lap object) in a cohort of professional occupational therapy students. Results This study found that all four interventions significantly reduced state anxiety. The sensory-based interventions of adapted dive reflex and weighted lap object appeared to have a longer duration of impact than the traditional interventions of deep breathing and PMR. Conclusion These results suggest that both traditional and sensory-based approaches may be effective in reducing anxiety before a testing situation.

Background:Cardiac catheterisations for CHD produce anxiety for patients and families. Current strategies to mitigate anxiety and explain complex anatomy include pre-procedure meetings and educational tools (cardiac diagrams, echocardiograms, imaging, and angiography). More recently, three-dimensionally printed patient-specific models can be added to the armamentarium. The purpose of this study was to evaluate the efficacy of pre-procedure meetings and of different educational tools to reduce patient and parent anxiety before a catheterisation.Methods:Prospective study of patients ≥18 and parents of patients Results:Twenty-three patients consented to participate, 16 had complete data for evaluation. Mean State-Trait Anxiety Inventory scores were abnormally elevated at baseline and decreased into the normal range after the pre-procedure meeting (39.8 versus 31, p = 0.008). Physician discussion, angiograms, and three-dimensional models were reported to be most effective at increasing understanding and reducing anxiety.Conclusion:In this pilot study, we have found that pre-catheterisation meetings produce a measurable decrease in patient and family anxiety before a procedure. Discussions of the procedure, angiograms, and three-dimensionally printed cardiac models were the most effective educational tools.

The purpose of this paper is to provide an overview of the recent research on android robotic media with a focus on its effects on older adults and to present a discussion on the implications of the experimental results. Social isolation of older adults is a leading issue in healthcare. Patients with dementia experience symptoms, such as agitation, which can result in increasing care burden. Android robotic media have been shown to provide a feeling of safety and communication support to older adults. In previous case studies, an increase in prosocial behaviors was observed in participants with dementia; however, the media effects needed to be measured by assessment scales. The current results indicate the effects of robotic media on dementia symptoms, especially the decrease in patients’ anxiety. As demonstrated in another experiment, anxiety reduction can also be expected in healthy older adults; however, certain conditions may be required for both healthy older adults and those with dementia. Key factors for the media effect, namely, dementia type, user’s personality, and personalized dialogue are taken into consideration for the further development of robotic systems. Additionally, we further discuss the significance of long-term data collection, especially from the early life stages because teleoperation or autonomous systems are expected to utilize information that can affect the effect of robotic media.

A clinical approach centered on teaching self-regulation and compassion can assist patients dealing with pain and anxiety to feel more control over their environment. Compassion, found to be a critical variable in the therapeutic benefit of mindfulness-based techniques, can be combined with biofeedback to maximize the advantageous psychological and physical changes that are seen with both. This article will present treatment considerations in a case in which compassion-based strategies within mindfulness-based biofeedback treatment were used with a patient experiencing anxiety related to pain and fear of undergoing a medical procedure for decannulation.

Objectives: To determine impact of an acupressure protocol on self-rated pain and anxiety scores. Design: Retrospective database analysis of self-rated pain and anxiety scores before and immediately after administration of stress release acupressure protocol. Participants: Participants include hospitalized patients, nurses, and public. Intervention: Involves a 16-point stress release acupressure protocol. Outcome measures: Outcome measures involve pre- and post-treatment self-rated pain scores (0–10) with the Wong-Baker Faces Scale and pre- and post-treatment self-rated anxiety scores (0–10) on a visual analog scale. Results: Five hundred and nineteen acupressure treatments were retrospectively analyzed with pre- and post-treatment self-rated pain and anxiety scores, where 0 represented no pain or anxiety and 10 represented the worst pain and anxiety. Overall, participants demonstrated a two-point decrease in pain scores and a four-point decrease in anxiety scores post-treatment. Hospitalized patients demonstrated a four-point decrease in pain scores and a five-point decrease in anxiety scores post-treatment. Nurses demonstrated a three-point decrease in pain scores and four-point decrease in anxiety scores post-treatment. Public population demonstrated a one-point decrease in pain scores and two-point decrease in anxiety scores post-treatment. Seventy-five percent of participants were highly satisfied with acupressure treatments, and 96% of treatments were administered in less than 30 minutes. Conclusions: Acupressure is a highly satisfactory complementary therapy that can demonstrate a clinically significant decrease in self-rated pain and anxiety scores.

Research has indicated that mental health disorders, particularly anxiety, predicts poorer antiretroviral medication adherence among persons living with HIV/AIDS (PLWHA). The present study tests a novel six-session Cognitive-Behavioral Therapy-based integrated treatment/management program for PLWHA with concurrent anxiety delivered in community health clinics Houston, Texas. Twenty-Seven PLWHA (

Background: Women undergoing cesarean delivery may have significant anxiety prior to surgery. Nonpharmacological approaches to anxiety reduction are favored in this patient population.Objective: Th...

To conduct a systematic review and meta-analysis to evaluate the effects of cold application on pain and anxiety reduction after chest tube removal (CTR).The act of removing the chest tube often causes pain among cardiothoracic surgery patients. Most guidelines regarding CTR do not mention pain management. The effects of cold application on reducing pain and anxiety after CTR are inconsistent.Systematic review and meta-analysis.We searched six databases, including Embase, Ovid Medline, Cochrane Library, Scopus, the Index to Taiwan Periodical Literature System and Airiti Library, to identify relevant articles up to the end of February 2021. We limited the language to English and Chinese and the design to randomised controlled trials (RCTs). All studies were reviewed by two independent investigators. The Cochrane Collaboration's tool was used to assess the risk of bias, Review Manager 5.4 was used to conduct the meta-analysis. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology was used for assessing certainty of evidence (CoE).Ten RCTs with 683 participants were included in the meta-analysis. The use of cold application could effectively reduce pain and anxiety after CTR. The subgroup showed that a skin temperature drops to 13°C of cold application was significantly more effective for the immediate reduction in pain intensity after CTR compared with control group. The GRADE methodology demonstrated that CoE was very low level.Cold application is a safe and easy-to-administer nonpharmacological method with immediate and persistent effects on pain and anxiety relief after CTR. Skin temperature drops to 13°C or lasts 20 min of cold application were more effective for immediate reduction of pain intensity following CTR.In addition to pharmacological strategy, cold application could be used as evidence for reducing pain intensity and anxiety level after CTR.

Objective: To evaluate the impact of the first outpatient evaluation on anxiety levels in women with suspected endometriosis. Secondarily, we investigated which individual characteristics exerted the greatest influence on distress levels. Methods: Women referred to our academic center between January 2019 and March 2020 on the suspicion of endometriosis were enrolled in this prospective, observational study. Before the visit, participants answered questionnaires such as the Generalized Anxiety Disorder-7 (GAD) and the Spielberg State Trait Anxiety Inventory (STAI) Y6. After the visit, the STAI-Y6 was resubmitted to each woman, along with the Patient Global Impression of Improvement (PGI–I) questionnaire. Women's and physicians' satisfaction with the visit were also evaluated using a 5-point scale. Results: One hundred and four women were enrolled. Anxiety levels decreased after the evaluation (STAI-Y6 60.0 ± 15.0 vs 40.8 ± 14.2, P

Most women experience moderate to severe pain during first-trimester surgical termination of pregnancy despite the application of various analgesic techniques. Studies have shown that virtual reality (VR) is effective in reducing anxiety among a range of women in differing circumstances. Our study objectives were to assess the feasibility of using VR during first-trimester dilation and curettage under local anaesthesia and understand the effect of VR on procedure-related anxiety during first-trimester dilation and curettage.A pilot feasibility study was conducted in a convenience sample of 30 women (15 in the intervention group and 15 in the control group). Anxiety scores were recorded before, during and after the procedure. In-depth interviews were conducted after the procedure.Participants reported that VR was either very effective (53%) or somewhat effective (40%) in relieving anxiety during and after the procedure. Eleven participants used the VR device for the entire procedure and four participants removed it during the procedure. The anxiety scores before the procedure were not significantly different between the groups. The intervention group had a median five point post-procedure decrease in anxiety score rated on a visual analogue scale, which was significantly different from that of the control group. Overall, participants had a positive experience but there were some technological frustrations.Women undergoing dilation and curettage in the first trimester were able to use a VR device during the procedure. VR-induced distraction and relaxation helped to reduce anxiety in some participants both during and after the procedure.

Aim : To assess the knowledge attitude and practice of usage of anti-anxiety drugs among the general dentalpractitioners.Background: Anti-anxiety drugs can act as effective way to manage patients with anxiety and dental fearmainly children. Adequate knowledge is necessary for using anti-anxiety drugs. Usage of anti-anxiety drugscan help to treat the patients in an effective way.Material and Methods: Questionnaires consisting of 15 questions was distributed to 80 general dentalpractitioners practicing in private dental hospitals and clinics in Chennai city in June 2017. The questionnairewas designed to enquire about the knowledge and usage of anti anxiety drug in childrenResults: 83.75% of dentists are aware of the pharmacological means of anxiety reduction. 51.25% are awareof the side effects and over dosage reaction of using anti anxiety drugs. 12% of dentists are aware of themethod of managing side effects and over dosage reaction of using anti anxiety drugsConclusion : Anti-anxiety drugs can act as a better alternative and also an adjunct to the conventionalbehaviour management. Proper knowledge about its mechanism of action, dosage, adverse effects areessential for the dentist to use anti-anxiety drugs in an effective way. Hence the usage of anti-anxiety drugscan be recommended and encouraged among dentists provided they have a sound knowledge about the drug

Background Weighted blankets have been used as a deep touch pressure (DTP) tool to alleviate anxiety in many patient populations. Patients with cancer can experience anxiety related to diagnosis and treatments, such as chemotherapy infusions. Research on the effectiveness of weighted blankets as a DTP tool to alleviate anxiety in patients receiving chemotherapy is limited. Objectives This study assessed the effectiveness of a medical-grade therapeutic weighted blanket on anxiety in patients receiving their first and second chemotherapy infusions at an outpatient infusion center. Methods A randomized controlled trial with a crossover design was performed with new patients in the outpatient chemotherapy infusion center. Patients were randomized to one of two study arms (given the weighted blanket during their first infusion or given the weighted blanket during their second infusion). Anxiety was measured using an anxiety inventory and a visual analog scale. Findings Anxiety was reduced among patients receiving chemotherapy when the weighted blanket was used. Based on the results, a standard-weight, medical-grade therapeutic weighted blanket can be safely used to reduce anxiety in patients of various weights, and a visual analog scale can be a reliable indicator of patients' state anxiety.

Color therapy, healing through color, supposedly works through the physical exposure to color. In two studies, we assessed stress and anxiety reduction after color exposure using a commercially available relaxation‐through‐color routine. Participants either completed the routine by looking at the accompanying color disks or at a white patch. In study 1 (longitudinal), 60 participants completed the routine three times, each testing session separated by a week. In study 2 (cross‐sectional), 63 participants completed half of the trials once. In both studies, we recorded a decrease in stress and anxiety levels comparing before‐after scores. In study 1, we recorded incremental decreases with each week. Crucially, decreases were the same whether participants (a) physically saw colors or not, and (b) completed the full or shortened version. We conclude that other factors but physical exposure to color explain changes in affective states associated with this and probably other color therapy routines.

Preoperative preparation is the first stage in the enhanced recovery pathway. Preoperative preparation includes a variety of processes required to set appropriate expectations for patients and their families and ensure fitness for surgery and transference of information. The latter, preoperative education is the focus of this chapter. Preoperative education although a fundamental part of the enhanced recovery pathway is one element of the pathway that is poorly researched. Although logically it could be assumed that it is necessary to educate patients, the majority of evidence is anecdotal. This chapter explores why educating patients prior to surgery is essential and how and by whom it should be undertaken. The limited details on the specifics involved in undertaking preoperative education are explored. Preoperative education appears in the main to be provided by nurses, and there is evidence that this information meets the patient’s needs. Additionally patient education empowers patients to be involved in their surgical pathway, which potentially results in a shorter hospital stay with fewer complications in hospital and after discharge home.

Objectives The purpose of this study was to systematically review the literature to describe the knowledge, attitude and practice of CAM by nurses. Methods Three databases were searched for relevant studies from launch through September of 2017 and included MEDLINE, Scopus and Web of science. Results The average knowledge of CAM therapies by nurses was 62.2% with attitude about use averaging 65.7%. Close to two-thirds (65.9%) reported use of CAM therapies with patients. The primary reasons nurses suggested use of CAM were for stress and anxiety reduction and health improvement. Conclusion Current evidence demonstrates the need for nurse education programs to integrate and strengthen CAM content into existing curricula. Similarly, documentation of the nature and extent of nurse use of CAM therapies in the clinical setting, as well as patient-reported use and preferences for CAM therapies, would provide valuable prospective data.

Die Anwendung der Ohrakupunktur kann zur Reduktion von akuten Schmerzen beitragen. Zu deren Einsatz in der zahnmedizinischen Akutschmerztherapie nach oralchirurgischen Eingriffen ist die Datenlage unzureichend. Diese Studie untersuchte die Effektivitat der Ohrakupunktur als additive Analgesiemethode zusatzlich zur Lokalanasthesie bei der operativen Zahnentfernung. In einer prospektiven, offenen, nichtrandomisierten Pilotstudie (entsprechend der CONSORT-Veroffentlichung) wurden 2 Kohorten mit jeweils 50 Patienten mit der Indikation zur operativen Zahnentfernung unter Lokalanasthesie mit Articain mit oder ohne den zusatzlichen Einsatz einer Ohrakupunktur hinsichtlich des Primarparameters Schmerzintensitat in Ruhe und unter Kaubelastung postoperativ bis zu zehn Tage beobachtet. Die Zuordnung zur Akupunkturgruppe erfolgte nach Patientenpraferenz und nicht randomisiert. Sekundare Parameter waren Angst und Symptome wie Schwindel oder Ubelkeit. Die demografischen Daten und der Verbrauch von Lokalanasthetika in beiden Gruppen unterschieden sich nicht signifikant. Signifikante Unterschiede zwischen den beiden Gruppen bestanden zu den verschiedenen Messzeitpunkten im Ruhe- und Kauschmerz (ANOVA, p = 0,004, p = 0,007), ebenso in der Angstempfindung (ANOVA, p = 0,0001), der Anzahl der Patienten mit einer Analgetikaeinnahme (χ2-Test, p = 0,017) und deren postoperativem Analgetikaverbrauch (T-Test, 0,001). Die NRS fur postoperative Kopfschmerzen, Schwindel und Ubelkeit nahmen in beiden Gruppen nur geringe Werte an. Trotz der Moglichkeit eines Erhebungsbias und methodologischer Einschrankungen im Studiendesign weist diese Untersuchung auf schmerz- und angstmodulierende Eigenschaften der Ohrakupunktur in der postoperativen Phase nach operativer Zahnentfernung hin. Moglicherweise kann Ohrakupunktur als nebenwirkungsarmes additives Verfahren, besonders bei Patienten mit praoperativer Angst, zur Reduktion postoperativer Schmerzen beitragen.

Anxiety and claustrophobic reactions in MRI examinations cause unintentional movements, and such motion artifacts lead to interpretation problems. Furthermore, requested anesthesia makes the process costly. A total of 60 outpatients were examined in the Diagnostic Centre of Pécs, Hungary, to test whether synchronizing recorded music to the gradient pulsation of the MRI device can improve the sedative effect of the music. The patients were assigned to three groups: a nonmusic (control), an original tempo (random) and a synchronized music (synchronous) group. Results showed a significantly decreased state anxiety level after the MRI examination in the random and synchronous groups as compared with the control group. However, there was no difference in the effectiveness of either music conditions regarding state anxiety level after the examination. Participants in the music groups found the examination significantly more pleasant compared with the control group. In conclusion, the present study provides support for the notion that listening to music during an MRI examination significantly reduces patient anxiety, whereas noise attenuating devices do not provide the same effect. peerReviewed

Introduction Music Care is a smartphone-based music intervention for pain and anxiety management that has previously been evaluated in large variety of patients with primary chronic painful conditions. The objective of this study was to evaluate the use of the app to reduce pain and anxiety in women attending an obstetrics before or during labor. Methods This observational study describes the first evaluation of the app in 62 women before or during labor in a department of obstetrics. Results Participants reported a significant reduction of pain intensity and anxiety after the use of the intervention, with small to moderate effect-size for pain reduction (ES 0.32) and large effect size for anxiety reduction (ES 0.76). Responder rates (> = 33% pre-post reduction of pain/anxiety) for ratings of pain intensity were at 31.6% (n = 19) and 50% for anxiety (n = 31). In general, participants rated high satisfaction with the intervention. Conclusion Overall, these data support the use of the Music Care app as adjuvant tool – in particular for the reduction of pain and anxiety in women in labor. More large-scaled and well-controlled studies are needed to further evaluate the effectiveness of this intervention.

Background: Dental anxiety and fear are the frequently encountered entities among most of the patients. The present study was conducted to assess the relationship between dental anxiety and quality of life (QoL). Materials and Methods: This study comprised of 118 patients. Dental trait anxiety (dental anxiety scale [DAS] and short version of the dental anxiety inventory [S-DAI]), Oral Health Impact Profile (OHIP-14), Decayed, Missing, and Filled Teeth (DMFT) score, and global assessment of functioning were recorded before and after treatment. Results: Out of 118 patients, males were 52 and females were 56. There was a correlation between both oral health ratings and DMFT (P < 0.001). OHIP-14 total score was significantly associated with both dental anxiety measures. DMFT shows significant association with dental anxiety and oral health-related QoL (OH-QoL) (P < 0.05). The mean DAS score before treatment was 17.3 and after treatment was 12.60, S-DAI score was 40.1 and 31.5 before and after treatment respectively, oral health status (patient rating) was 38.4 and 74.20 before and after treatment respectively, oral health status (dentist rating) was 38.7 and 73.1 before and after treatment respectively and aesthetics (dentist rating) was 35.6 and 72.4 before and after treatment respectively. There was improvement of OH-QoL with dental anxiety reduction which was significantly significant (P < 0.05). Conclusion: Authors found that there is correlation between dental anxiety and fear with the poor oral health-related oral hygiene.

Background Atomoxetine and methylphenidate are widely used to treat attention-deficit–hyperactivity disorder (ADHD) with similar effectiveness after 8 weeks of treatment, when atomoxetine has reached its a full effect. Both drugs have also been shown to have an effect on comorbid anxiety. To the best of our knowledge, no study has compared their effect on the dynamics of anxiety symptom reduction. The aim of this study was to compare the medication effect on core and comorbid anxiety symptom dynamics in children with ADHD. Methods Sixty-nine patients participated in the study: 36 patients were taking atomoxetine and 33 patients, methylphenidate. Therapeutic effect on core symptoms of ADHD was measured on the ADHD-rating scale IV, and symptoms of anxiety were measured using the Conners Parent Rating Scale (CPRS). Symptoms were measured prior to and every 2 weeks during 8 weeks of treatment. Results There was a significant decrease in CPRS anxiety subscale score in both medication groups. Anxiety subscale score was significantly lower in the atomoxetine group in the fourth week, and lasted through to 8 weeks of medication. Conclusion Both atomoxetine and methylphenidate reduced the symptoms of ADHD and anxiety. Atomoxetine was more effective in anxiety symptom reduction from the fourth week of treatment.

After the Fukushima Daiichi nuclear accident in 2011 and thyroid examinations of children in Fukushima, the Radiation Medical Science Center began "Explanatory meetings on thyroid examination" as a method of communication with residents such as the subjects themselves and their guardians. Through questionnaires, we examined the relationship between anxiety (regarding the effects of radiation on the thyroid) before the meetings and individual attributes including attitudes on radiation, and then verified the effects of the meetings using measures of anxiety, comprehension, and satisfaction, as the outcomes. Of the meetings in 2014-2015, 799 people attended 30 sessions in Kenchu, Kenpoku, Iwaki, Soso, and outside of Fukushima Prefecture, and 594 people responded the questionnaires before and after the meetings on the same day. Level of anxiety before the meetings varied depending on individual attributes (including attitudes regarding collection information on radiation, advisors on radiation, and levels of subjective understanding), highlighting the importance of presenting information about radiation in a manner that is easy to understand, as well as providing opportunities for the exchange of opinions. Participation in meetings reduced anxiety. This was largely attributed to explanations about general characteristics of cancer and objective facts, including doses; status of the Chernobyl accident; and comparison in results of thyroid examinations with other prefectures in Japan. An opportunity for a question-and-answer session also contributed to increased overall satisfaction. The lower number of meeting participants was associated with anxiety reduction and higher subjective comprehension. The present findings obtained will be useful to facilitate evidence-based risk communication.

The aim of this study is to assess the prevalence of preoperative anxiety among Nigerian Hausa patients undergoing elective surgery. Methods: Thirty patients between the ages of 17- 64 years scheduled to undergo elective surgery in a tertiary health facility in northern Nigeria were recruited and administered a translated Hausa version of the Amsterdam Preoperative Anxiety and Information Scale (APAIS-H).APAIS-H was administered to each patient in the evening before and in the morning of their surgery day. Results: Statistical Package for Social Sciences (SPSS) Version 23.0 was used to analyze the data. Analyses were according to the APAIS subscales to see preoperative anxiety a day before and on the day of surgery. On both the fear of anesthesia and fear of surgery subscales, 76.6% of the participants presented with low to moderate anxiety in the evening proceeding the day of their surgery. Only 23.3% of the participants were highly anxious about either anesthesia or surgery in the evening proceeding the day of their surgery. On the anxiety related to surgery subscale, in the morning of the surgery day, 36.7% of the participants had low to moderate anxiety related to anesthesia while 63.3% were highly anxious about anesthesia. Also, 40% of the participants presented with low to moderate anxiety related to surgery in the morning of their surgery while the remaining 60% were highly anxious about the surgery in the morning of the day of their surgery. The full-scale preoperative anxiety scores reveal that 53% of the participants had low anxiety, 26.7 had moderate anxiety while 20% of participants had high preoperative anxiety in the evening preceding their surgery. In the morning of the day of their scheduled surgery, 20% of the participants presented with low anxiety, another 20% had moderate anxiety while the remaining 60% had high preoperative anxiety. Conclusion: The findings of the study show that anxiety before elective surgery is prevalent among Hausa patients. It is therefore recommended that adequate psychological preoperative anxiety reduction interventions be put in place to address patients’ anxiety to achieve a better surgical outcome .

Little research exists on using clay as an anxiety-reducing intervention with patients in psychiatric hospitals. This article reports on a study that used a one-group, pretest/posttest design with 49 adults in a psychiatric facility who created a clay pinch pot. The State-Trait Anxiety Inventory (STAI) was used as a pre- and posttest measure. Results revealed a significant decrease in anxiety and a significant gender interaction. Pretest mean scores for men were higher than those for women, rendering the amount of anxiety reduction significantly greater for men. These results provide evidence that clay work may effectively reduce state anxiety for adult psychiatric inpatients.

OBJECTIVES This study investigates the relationship between anxiety reduction and functional outcomes in children and adolescents receiving intensive interdisciplinary rehabilitation services for chronic pain (CP). Specifically, we evaluated whether: (1) anxiety changes over the course of treatment; (2) anxiety covaries with functional outcomes to rehabilitation; and (3) change in anxiety predicts change in functional outcomes from rehabilitation for CP. Using 3 separate measures assessing anxiety-related constructs, we hypothesized that anxiety would be associated with functioning, both before and following intensive rehabilitation for CP. Further, we hypothesized that a decrease in anxiety-related symptoms following rehabilitation would predict a positive change in functional outcomes. MATERIALS AND METHODS Our sample consisted of 119 children and adolescents treated for CP in an interdisciplinary rehabilitation program between 2007 and 2012. Children completed 3 measures related to anxiety (general anxiety, pain-specific anxiety, pain catastrophizing) and 2 functional outcome measures (eg, Bath Adolescent Pain Questionnaire, PedsQL) as part of clinical care. RESULTS Measures of anxiety-related constructs were significantly correlated with measures of impairment and functioning, both at admission and at 1-month postdischarge. Regression analyses demonstrated that, after controlling for age, sex, and pain level at admission, a decrease in anxiety significantly predicted between 14% and 40% unique variance in functional outcomes. DISCUSSION The findings of this study support existing research on anxiety and CP, specifically the relationship between anxiety and pain-related disability. This study also supports the benefit of intensive interdisciplinary rehabilitation for both reducing anxiety and increasing functional outcomes, suggesting a possible link in children's response to intervention. Study limitations and future directions for related research are discussed.

Objetivo: avaliar a realização de intervenções educativas para os cuidadores de crianças com cardiopatia congênita como estratégia para redução do nível de ansiedade. Métodos: Estudo do tipo grupo intervencionista, realizada em um hospital de referência de Pernambuco, no período de junho a setembro de 2014. Resultados: Participaram do estudo 32 cuidadores de crianças com cardiopatia congênita. Observou-se que os cuidadores de crianças com cardiopatia congênita apresentaram-se com nível de ansiedade menor após as intervenções educativas realizadas pelo enfermeiro no pré-operatório quando comparados com os que não receberam (12,47±8,98 versus 17,12±10,46). Conclusão: Conclui-se que as estratégias de intervenção educativa produzem efeitos positivos na melhoria do grau de ansiedade em cuidadores de crianças com cardiopatia congênita.

Childbirth is a great moment in a woman's life and is inevitably influenced by emotional, social, and psychological stress. This study aimed to assess the anxiety and pain level of nulliparous women giving birth using physiological methods (without doula support) during labor and those women supported by a doula at Towhid Hospital of Jam, Bushehr, Iran in 2015. In this interventional study, 150 women were randomly assigned to either an intervention (with doula support) or a control group (with no doula support). The intrapartum, postpartum, and hidden anxiety levels were measured using Spielberger standard questionnaire used for assessing anxiety. The labor pain rate was evaluated using McGill questionnaire. Results showed that the average rate of obvious anxiety during labor was 57.76 ± 9.57 in physiological delivery (without doula) and 48.04 ± 9.61 in doula-supported delivery. The difference between mean scores of obvious anxiety during labor was significant. The mean anxiety of the control group (who did not receive doula support) was higher (P = .000). Also, the difference between the mean labor pain scores of the 2 groups was statistically significant. The results of the study showed that doula's presence has positive significant effects on labor pain and anxiety reduction; also, doula-supported mothers reported considerably lower pain and anxiety compared with those experiencing physiological delivery (without doula). Thus, the increased use of doula in hospitals all over the country is recommended.

Daily clinical practice is an important source of stress and emotional exhaustion. In the health field, patients could experience a significant number of emotional reactions. There are high levels of anxiety in patients referred for medical imaging, and these levels are even higher in patients undergoing complicated diagnostic procedures. All this shows the need to understand that anxiety must be diagnosed and treated. This situation forces radiologist to develop emotional and social skills to resolve difficulties that may arise in the communicative act. In the patient-radiologist interaction, many elements have been analysed, being communication and communicative skills one of the most important elements. The objective is to present an emotional management tool, the U-technique. It consists of four movements: sympathize, empathize, feel the antidote emotion and spread the antidote emotion in order that the health professionals recognize their emotional state in each moment of the relationship with the patient.

This study aimed to evaluate the effectiveness of massage with or without guided imagery in reducing anxiety prior to cardiac catheterization.A total of 55 inpatients and outpatients received massage, guided imagery, or massage with guided imagery prior to cardiac catheterization. Self-reported anxiety levels and blood pressure (BP) and heart rate (HR) were evaluated in participants and a matched comparison group.Massage with and without guided imagery resulted in significant reductions in self-reported anxiety (p 0.0001). Patients receiving intervention had lower diastolic BP and HR vs. the comparison group (p 0.0001 and p 0.05).Massage with or without guided imagery immediately reduced self-reported anxiety. This pilot study has certain limitations: a non-randomized, convenience sample and a matched control group that was created retrospectively. However, the study indicates a benefit to providing massage or massage with guided imagery prior to anxiety-inducing medical procedures such as cardiac catheterization.

Sixty-four primary school going boys of the Indian sub-continent in the age range of 9-12 years having high trait anxiety and attention-deficits, volunteered as the participants in this experiment. Half of them were recruited from residential academic institution in Bangladesh, while their counterparts were selected from identical residential academic institution in India. For the experiment proper, in both of the set-ups participants were categorised into two groups, viz. Gr. A (Control group, not exposed to any intervention program) and Gr. B (Experimental group, received Abbreviated version of Progressive Muscle Relaxation – (APMR training). Both groups were subjected to the pre-intervention assessment of attentive capacity, electrical muscle potentiality and different variables of skin conductance measure (as indices of heightened emotionality). Thereafter Gr. B boys were introduced to the training of APMR (monitored training of APMR for 15 min.s/day; three days/week) for a period of two months during the afternoon sessions under the guidance of a qualified and trained instructor. Post-intervention assessment and follow up assessment (after two months), on all the aforesaid variables however revealed that in both of the set-ups (in Bangladesh as well as in India) training and subsequent monitored long-term practice of APMR was found effective in reducing anxiety level and in developing better attentive capacity in the children of the both of the countries, who were exposed to the respective intervention. Improvement in frontalis muscle tension and in the basal skin conductance level along with higher autonomic habituation as an impact of long-term and regulated APMR training was suggested as facilitator of sustainable improvement in attentive capacity in the children.

Araki, Shimazaki, Imai, & Ito (2008) indicated that listening to preferred music for days gradually reduced the level of state anxiety. Hereinafter, this study is called the accumulated effect. To our knowledge, there is no paper replicated this accumulated effect. So, the first aim of the current study was to examine whether the accumulated effect could be replicated. Furthermore, as a second aim, this study explored whether the above accumulated effect could last for at least two day. In order to achieve the two aims, the procedure of this study consisted of such as follows. At first, all participants completed the state anxiety scale of Japanese Edition (Mizuguchi, Shimonaka, & Nakasato, 1999) of State-Trait Anxiety Inventory (STAI; Spilberger, Gorsuch, & Lushene, 1970). After that, they were asked to listen to the preferred music or white noise. The preferred music was selected by the participant, while white noise was presented by the experimenter. After listening, all participants again completed the state anxiety scale. This session (STAI measurement-music listening-STAI measurement) was undergone once per day for three consecutive days. On day two after music listening on the 3rd day, they again completed state anxiety scale and answered the interview at follow-up to examine whether the accumulated effect could last. The results indicated that only in high anxiety individuals, listening to preferred music for three consecutive days gradually decreased state anxiety score by the day. Thus, the accumulated effect was replicated. Moreover, in high anxiety group, there was no difference between the state anxiety score on the 3rd day and that on day two after preferred music listening on the 3rd day. Consequently, the accumulated effect lasted afterward via preferred music listening for three consecutive days.

Zusammenfassung. Theoretischer Hintergrund: Dysfunktionale Kognitionen stellen den Kern des kognitiv-behavioralen Modells zur Erklärung psychischer Störungen dar. Fragestellung: In einer Längsschnittstudie wird geprüft, ob die Reduktion von Angst- und depressiver Symptomatik mit dem Ausmaß und der Reduktion dysfunktionaler Kognitionen zusammenhängt. Methode: N = 87 Patienten mit den Diagnosen Zwangsstörung, Major Depression und Panikstörung bzw. Agoraphobie beantworteten vor und nach einer kognitiven Verhaltenstherapie Fragebögen zu Symptomatik, dysfunktionalen Einstellungen, Sorgen und Grübeln. Ergebnisse: Die Patienten verbessern sich im Therapieverlauf hinsichtlich kognitiver Inhalte und Prozesse sowie der Belastung. Ausgeprägte Sorgen zu Therapiebeginn korrelieren mit weniger Besserung ängstlicher Symptomatik, Reflektion ist dagegen ein protektiver Faktor. Die Abnahme dysfunktionaler Einstellungen sagt die Reduktion der Ängstlichkeit, die Abnahme des Sorgens die Reduktion der Depressivität vorher. Schlussfolgerungen: Die Annahmen des kognitiv-behavioralen Modells werden gestützt.

The use of general anaesthesia for dental treatment in the NHS outside hospitals has changed over time. Although deaths are uncommon during or immediately after general anaesthesia for dental treatment, they are more likely to occur than with other methods of pain and anxiety reduction, such as local anaesthesia and conscious sedation. Inquiries into recent anaesthetic deaths in dental practice have been critical of the standard of care provided in areas such as pre-operative assessment, monitoring, resuscitation and transfer to specialist critical care facilities.1

One of the psychological states that can be monitored and influenced during learning in order to improve its various aspects is the state of anxiety, and one possible index of this state is frontal EEG beta. However, frontal EEG beta has also been associated with mental activities. This may imply that frontal EEG beta would not be a reliable index of anxiety in situations, such as learning, where significant mental activities can be involved. The present study investigated the relationship between frontal EEG beta and anxiety during computer-based learning. The frontal EEG beta and anxiety levels of four groups of 15 students were measured during learning conditions that comprised any of combinations of anxiety reduction and mental activities, anxiety reduction alone, or no treatment. The groups that combined anxiety reduction with mental activities showed significant increase in frontal EEG beta even though they recorded significant reduction in subjective anxiety. This may suggest that frontal EEG beta is not a reliable index of anxiety during computer-based learning.

The literature on the use of family meals as a focus for treatment in anorexia nervosa is now quite old and interest in this area, both clinical and academic appears to have waned. In this paper we explain the use of family meals in our treatment of adolescent eating disorder patients. Whereas earlier descriptions tend to use the language of structural family therapy and emphasize intensification, we focus more on collaboration and on anxiety reduction. Copyright © 2002 John Wiley & Sons, Ltd and Eating Disorders Association.

Summary The aim of this paper is to discuss the mechanisms and magnitude of the placebo effect of treatment and to consider the ethical and moral implications of using placebo physiotherapy. Placebo or non-specific treatment effects were long considered to contribute a fixed fraction (one-third) to any treatment effect. Recent evidence has revealed this commonly held clinical belief to be erroneous. The placebo effect of any treatment is a highly variable and complex phenomenon that is influenced by a myriad factors. The outcome may be positive (eg analgesia) or negative (eg increased dependency on healthcare practitioners). Although the mechanisms of effect are not fully understood, evidence supports the influence of classical conditioning, anxiety reduction, and the expectations of both patients and practitioners. The relationship between patients and practitioners influences the magnitude of placebo effects as does the method of treatment presentation. A charismatic or caring practitioner can evoke analgesia with or without further treatment. And treatment presented with an air of ‘mystery‘, apparent sophistication, or positive expectation can evoke analgesia simply through the method of its presentation. Questions regarding the ethical use of treatments that are primarily placebo need to be addressed. When and under what conditions are placebo treatments acceptable in the short or long term? Is it a benevolent lie, or a regular lie, to use treatments that have only placebo effects? And, perhaps more importantly, do we know what those treatments are?

Our purpose was to examine the effects of cognitive group therapy, aerobic exercise, or their combination on anxiety reduction. Seventy participants were divided into four groups: cognitive group therapy, aerobic exercise, both treatments, or control. Participants were administered the State-Trait Anxiety Inventory (STAI) before and after the study, and at a two-month follow-up. Results indicate that all interventions were equally effective in reducing anxiety as compared to no intervention. The combination of cognitive group therapy and exercise was not significantly more effective than either cognitive group therapy or aerobic exercise alone. Although effects were not maintained after two months, it is unclear whether this is attributable to the limitations of such interventions in changing more enduring traits. Possible mechanisms for change are discussed.

Objective. One symptom common to many persons with autism is a high arousal or anxiety level. This study investigated the effects of deep pressure on arousal and anxiety reduction in autism with Grandin’s Hug Machine, a device that allows self-administration of lateral body pressure. Method. Twelve children with autism were randomly assigned to either an experimental group (receiving deep pressure) or a placebo group (no receiving deep pressure but in the disengaged Hug Machine). All children received two 20-min sessions a week over a 6-week period. Arousal was measured behaviorally with the Conners Parent Rating Scale and physiologically with galvanic skin response (GSR) readings. Results. Behavioral results indicated a significant reduction in tension and a marginally significant reduction in anxiety for children who received the deep pressure compared with the children who did not. Additionally, children in the experimental group, whose GSR measure decreased, on average, after deep pressure, were somewhat more likely to have higher GSR arousal a priori. Conclusion. These preliminary findings support the hypothesis that deep pressure may have a calming effect for persons with autism, especially those with high levels of arousal or anxiety.

Background/methods This article presents the results of the application of hypnotherapy for obstetrics with a special focus on the hypnoreflexogenous method of childbirth preparation. Results/conclusion The programme specifically developed by Schauble as the hypnoreflexogenous method is an appropiate and efficient tool to interrupt the fear-tension-pain / pain-tension-fear circuit. Women who were prepared with the hypnoreflexogenous method had significantly less fear and pain, required significantly less analgesia, had a shorter period of labour and delivery and recovered faster from labour.

Therapeutic Touch, a modern application of the ancient technique of “Laying on of Hands, “ has proven to be a successful adjunct to current medical treatments, ranging from post-operative pain control and tension headaches2 to anxiety reduction in hospitalized cardiovascular patients.3 While Therapeutic Touch has gained acceptance and has been integrated into many major medical centers, it has not been widely used or documentecl with people afflicted with Alzheimer's disease. The AlZheimer's Resource Center of Connecticut has trained staff (and alsofamilies of patients) in the practice of Therapeutic Touch, beginning with a six-month training periodfor staff in July 1996. During this time, staff performed the technique strictly on each other to learn and refine their skills. In February 1997, the group began to perform Therapeutic Touch on patients. On a case-by-case basis, staff have observed that, following treatments of Therapeutic Touch, patients have demonstrated visible signs of well-being and relaxation-often leading to sleep. Staff also found Therapeutic Touch a way to positively forge emotional connections with patients who are verbally uncommunicative and who sufferfrom varying degrees of dementia.

There is disparate evidence within the current literature concerning the nature and level of involvement that physiotherapists have with patients suffering from anorexia nervosa. The study outlined in this article investigated such issues. Physiotherapists actively working with anorexic patients were targeted using a postal questionnaire. Results indicated that there is an active involvement of physiotherapists within the multidisciplinary team in the management of anorexia, and that the application of physical treatments were appropriate in a condition that is largely regarded as a psychiatric/psychological problem. In particular, physiotherapy was perceived as a useful application in the management of distorted body image, in programmes to control excessive exercise and in anxiety reduction.