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There are many examples of mind-body connection.
Taking advantage of this principle, health care providers are increasingly using holistic approaches to treat chronic diseases.
A new approach could have a significant impact on people with chronic obstructive pulmonary disease (COPD). For these patients, the feeling of "hungry for air" or the inability to breathe is terrifying.
Text indicating Cognitive Behavioral Therapy (Courtesy of Getty)Getty
Anticipating episodes of difficulty breathing can increase the anxiety that triggers exacerbations of this chronic disease, in which spasms of small airways restrict the ability to breathe normally.
New research now shows that cognitive behavioral therapy (CBT) administered by respiratory nurses is not only cost-effective, but also reduces the symptoms of anxiety in patients with chronic obstructive pulmonary disease (COPD).
The research was published earlier this week in ERJ Open Research.
COPD is a chronic condition that results primarily from irritants in cigarette smoke, but also exposure to second-hand smoke or air pollution. It causes inflammation of the lungs, spasms of the airways called bronchioles and eventually leads to the destruction of lung tissue, making it difficult to breathe. Inhaled corticosteroids, long-acting beta-agonists (LABA) and long-acting muscarinic antagonists (LAMA) are often used as the main treatment.
Since anxiety is relatively common in patients with COPD, this may result in less physical activity, resulting in loss of muscle tone (deconditioning), but also isolation and deterioration of health.
CBT is a type of "speech therapy" that aims to understand the connection between a patient's situation, symptoms and physical complaints as well as his emotions, thoughts and behavior. The current guidelines on the treatment of anxiety and depression recommend CBT, counseling, self help, taking medications or a combination of these approaches.
Research revealed that when study patients followed short CBT sessions structured with nurses in pneumology, they felt better overall, less anxiety Exacerbations of COPD and performed fewer emergency visits.
Dr. Karen Heslop-Marshall, nurse consultant at the Newcastle-upon-Tyne NHS Foundation Trust and at the University of Newcastle, UK, and senior researcher of the study, explained in a Press release that one of the main symptoms of COPD is shortness of breath.
"It's very scary and often leads to feelings of anxiety," she explained. "Many health professionals are not currently seeking anxiety symptoms in COPD patients, although this may affect their overall health."
"Feeling anxious has a negative impact on the quality of life of patients and leads to more frequent use of health care resources." We wanted to see if individual CBT sessions provided by respiratory therapy nurses would reduce symptoms. anxiety and cost-effective intervention, "she added.
236 patients with a mild to severe diagnosis of COPD participated in the study. Each patient was screened for anxiety using the HADS-Anxiety Subscale subscale, a questionnaire that asked patients about their feelings of anxiety and depression over the past week. Scores between 8 and 10 are considered to have mild symptoms, 11-14 moderate symptoms and more than 15 more severe symptoms.
All patients who participated in the study scored 8 or higher on the HADS scale. And overall, 59% of people examined before enrollment in the study had a high HADS score, suggesting that anxiety is quite common in COPD.
Over a period of three months, patients received either written information (self-help leaflets) on how to handle anxiety, or provided with leaflets accompanied by a TBI. During CBT sessions, nurses taught patients how to develop coping strategies to cope with anxiety from shortness of breath, as well as tips on how to improve physical activity levels.
All patients in the study received standard medical care for COPD, including pulmonary function tests and the same medications. Eligible patients at higher risk of deterioration also benefited from pulmonary rehabilitation, a supervised exercise program designed for patients with COPD.
At the end of 3 months, patients completed the HADS-Anxiety questionnaire again to understand if different treatment regimens affected the level of anxiety.
The researchers found that CBT was more effective at reducing the symptoms of anxiety in COPD patients than written information alone. The HADS-Anxiety Scale scores of patients under CBT improved 3.4 on average, while those who received written information improved only 1.9 on average.
The researchers also found that for every patient with a TBI, an average saving of £ 1,089 per hospitalization and £ 63 for emergency visits.
Interestingly, the study showed no correlation between the patient's lung function, measured by the amount of air that a person can exhale in one second (FEV1), and his anxiety score. Researchers believe this suggests that even patients with mild COPD may feel anxious and likely benefit from CBT.
" We found that individual CBT sessions given by nurses in pneumology could reduce the symptoms of anxiety. and that this could be a cost-effective intervention, "Heslop-Marshall explained. "Although TCC's intervention initially resulted in additional costs, as respiratory nurses needed to be trained in CBT techniques, these savings were offset by savings from the reduced need for hospital services and surgical and repair services. "
"Reducing the level of anxiety felt by patients has a significant impact on their quality of life, their ability to remain physically active and can improve their long-term survival. Our research shows that front-line respiratory personnel can perform this procedure effectively and efficiently. , "she added.
One of the limitations of the study was that it was not possible to blindly indicate the treatment method they received, which may have influenced their responses to the second HADS questionnaire. The researchers were also unable to determine which specific element of CBT intervention, namely coping strategies to cope with scary thoughts, rhythm stimulation, breath control, distraction or the promotion of physical activity, was the most effective in reducing feelings of anxiety.
One of the unique aspects of this study is the use of qualified nurses in respiratory care to assess the mental health needs of this particular population struggling with medical and psychological issues. The authors argue that barriers to accessing mental health services in this population, such as perceived stigma, and the fact that these patients place a higher priority on medical care, have prompted the introduction of this unique approach to treat mental health problems.
Dr. Thierry Troosters of the Katholieke Universiteit Leuven, Belgium, elected President of the European Society of Pneumology and not involved in research, explained in a Press release that "COPD is a major burden for individuals, societies and health systems around the world.This is due in part to continued exposure to COPD risk factors, such as smoking and smoking. air pollution, and partly to the aging of the population ".
"This research shows how the use of a multidisciplinary approach to the treatment of COPD can reduce the burden on patients and health services ", Proposed Troosters. "Treating patients for concomitant conditions such as anxiety greatly helps to improve their overall health, and these methods can be cost-effective," he added.
"The care provided by dedicated and well-trained health professionals also makes it possible to quickly refer patients with more serious mental disorders to even more specialized care settings," he concluded.
Implementing such a program in the United States may be difficult, but given the growing role of nurse practitioners and physician assistants, it is not out of the question.
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There are many examples of mind-body connection.
Taking advantage of this principle, health care providers are increasingly using holistic approaches to treat chronic diseases.
A new approach could have a significant impact on people with chronic obstructive pulmonary disease (COPD). For these patients, the feeling of "hungry for air" or the inability to breathe is terrifying.
Text indicating Cognitive Behavioral Therapy (Courtesy of Getty)Getty
Anticipating episodes of difficulty breathing can increase the anxiety that triggers exacerbations of this chronic disease, in which spasms of small airways restrict the ability to breathe normally.
New research now shows that cognitive behavioral therapy (CBT) administered by respiratory nurses is not only cost-effective, but also reduces the symptoms of anxiety in patients with chronic obstructive pulmonary disease (COPD).
The research was published earlier this week in ERJ Open Research.
COPD is a chronic condition that results primarily from irritants in cigarette smoke, but also exposure to second-hand smoke or air pollution. It causes inflammation of the lungs, spasms of the airways called bronchioles and eventually leads to the destruction of lung tissue, making it difficult to breathe. Inhaled corticosteroids, long-acting beta-agonists (LABA) and long-acting muscarinic antagonists (LAMA) are often used as the main treatment.
Since anxiety is relatively common in patients with COPD, this may result in less physical activity, resulting in loss of muscle tone (deconditioning), but also isolation and deterioration of health.
CBT is a type of "speech therapy" that aims to understand the connection between a patient's situation, symptoms and physical complaints as well as his emotions, thoughts and behavior. The current guidelines on the treatment of anxiety and depression recommend CBT, counseling, self help, taking medications or a combination of these approaches.
Research revealed that when study patients followed short CBT sessions structured with nurses in pneumology, they felt better overall, less anxiety Exacerbations of COPD and performed fewer emergency visits.
Dr. Karen Heslop-Marshall, nurse consultant at the Newcastle-upon-Tyne NHS Foundation Trust and at the University of Newcastle, UK, and senior researcher of the study, explained in a Press release that one of the main symptoms of COPD is shortness of breath.
"It's very scary and often leads to feelings of anxiety," she explained. "Many health professionals are not currently seeking anxiety symptoms in COPD patients, although this may affect their overall health."
"Feeling anxious has a negative impact on the quality of life of patients and leads to more frequent use of health care resources." We wanted to see if individual CBT sessions provided by respiratory therapy nurses would reduce symptoms. anxiety and cost-effective intervention, "she added.
236 patients with a mild to severe diagnosis of COPD participated in the study. Each patient was screened for anxiety using the HADS-Anxiety Subscale subscale, a questionnaire that asked patients about their feelings of anxiety and depression over the past week. Scores between 8 and 10 are considered to have mild symptoms, 11-14 moderate symptoms and more than 15 more severe symptoms.
All patients who participated in the study scored 8 or higher on the HADS scale. And overall, 59% of people examined before enrollment in the study had a high HADS score, suggesting that anxiety is quite common in COPD.
Over a period of three months, patients received either written information (self-help leaflets) on how to handle anxiety, or provided with leaflets accompanied by a TBI. During CBT sessions, nurses taught patients how to develop coping strategies to cope with anxiety from shortness of breath, as well as tips on how to improve physical activity levels.
All patients in the study received standard medical care for COPD, including pulmonary function tests and the same medications. Eligible patients at higher risk of deterioration also benefited from pulmonary rehabilitation, a supervised exercise program designed for patients with COPD.
At the end of 3 months, patients completed the HADS-Anxiety questionnaire again to understand if different treatment regimens affected the level of anxiety.
The researchers found that CBT was more effective at reducing the symptoms of anxiety in COPD patients than written information alone. The HADS-Anxiety Scale scores of patients under CBT improved 3.4 on average, while those who received written information improved only 1.9 on average.
The researchers also found that for every patient with a TBI, an average saving of £ 1,089 per hospitalization and £ 63 for emergency visits.
Interestingly, the study showed no correlation between the patient's lung function, measured by the amount of air that a person can exhale in one second (FEV1), and his anxiety score. Researchers believe this suggests that even patients with mild COPD may feel anxious and likely benefit from CBT.
" We found that individual CBT sessions given by nurses in pneumology could reduce the symptoms of anxiety. and that this could be a cost-effective intervention, "Heslop-Marshall explained. "Although TCC's intervention initially resulted in additional costs, as respiratory nurses needed to be trained in CBT techniques, these savings were offset by savings from the reduced need for hospital services and surgical and repair services. "
"Reducing the level of anxiety felt by patients has a significant impact on their quality of life, their ability to remain physically active and can improve their long-term survival. Our research shows that front-line respiratory personnel can perform this procedure effectively and efficiently. , "she added.
One of the limitations of the study was that it was not possible to blindly indicate the treatment method they received, which may have influenced their responses to the second HADS questionnaire. The researchers were also unable to determine which specific element of CBT intervention, namely coping strategies to cope with scary thoughts, rhythm stimulation, breath control, distraction or the promotion of physical activity, was the most effective in reducing feelings of anxiety.
One of the unique aspects of this study is the use of qualified nurses in respiratory care to assess the mental health needs of this particular population struggling with medical and psychological issues. The authors argue that barriers to accessing mental health services in this population, such as perceived stigma, and the fact that these patients place a higher priority on medical care, have prompted the introduction of this unique approach to treat mental health problems.
Dr. Thierry Troosters of the Katholieke Universiteit Leuven, Belgium, elected President of the European Society of Pneumology and not involved in research, explained in a Press release that "COPD is a major burden for individuals, societies and health systems around the world.This is due in part to continued exposure to COPD risk factors, such as smoking and smoking. air pollution, and partly to the aging of the population ".
"This research shows how the use of a multidisciplinary approach to the treatment of COPD can reduce the burden on patients and health services ", Proposed Troosters. "Treating patients for concomitant conditions such as anxiety greatly helps to improve their overall health, and these methods can be cost-effective," he added.
"The care provided by dedicated and well-trained health professionals also makes it possible to quickly refer patients with more serious mental disorders to even more specialized care settings," he concluded.
Implementing such a program in the United States may be difficult, but given the growing role of nurse practitioners and physician assistants, it is not out of the question.
