Mindfulness-baseret kognitiv terapi i en sundhedspsykologisk kontekst: effektstudier og kliniske betragtninger fra Enhed for Psykoonkologi og Sundhedspsykologi

Mindfulness-based cognitive therapy (MBCT) was originally developed to prevent recurrent depression, but may also be of relevance for patient groups in the field of health psychology. The present paper gives a descriptive overview of clinical trials conducted at theUnit for Psychooncology and Health Psychology (EPoS) with the overall purpose of exemplifying research-related and clinical considerations in the field. Our studies indicate that a generic application of MBCT reduces pain intensity among women treated for breast cancer,as well as depression symptoms related to spousal bereavement in old age. Furthermore, ongoing studies will yield results on the effect of disease-specific versions of MBCT adjusted to the special needs of other populations in the field of health psychology. Finally, the importance of MBCT instructor qualification is briefly discussed and specific experiencesin relation to how these qualification criteria can be met are described

Changes in COPD-related anxiety symptoms during pulmonary rehabilitation: a prospective quantitative and qualitative study

BackgroundFear-avoidance in COPD can have detrimental effects on pulmonary rehabilitation (PR) outcomes and is therefore important to address. This prospective study examined changes in and management of COPD-related anxiety symptoms over the course of a PR program.MethodsPatients with COPD referred to 9-weeks of PR in the municipality of Vejle, Denmark from January to December 2022 completed a six-minute walk test (6MWT) and the following questionnaires, both before and after PR: COPD Anxiety Questionnaire 20-item version (CAF-R), measuring COPD-related anxiety; COPD Assessment Test (CAT), measuring COPD-related disability; 12-Item Short-Form Health Survey (SF-12), measuring health-related quality of life (HR-QoL); sociodemographic and disease-related information. After PR, a subsample of the patients took part in semi-structured interviews exploring their understanding of how they managed COPD-related anxiety during PR. Pre- and post-assessment of COPD-related anxiety and other PR outcomes were analysed with t-tests and correlation analyses. Qualitative interviews were analysed using a thematic analysis approach.ResultsA total of 72 patients with COPD (mean ± SD age 71 ± 8, 53% female) were included in the study, and 13 took part in qualitative interviews. A significant decrease in COPD-related anxiety was observed from before to after PR, corresponding to a small effect size (Cohen's d = 0.32; p = 0.018). Reductions in COPD-related anxiety were not associated with improvements in COPD-related disability, HR-QOL, or functional exercise capacity. The qualitative findings identified four anxiety management strategies, i.e., “planning”, “problem-solving”, “accepting”, and “confronting”, which were influenced by interactions with healthcare professionals and co-patients as well as patients’ own perception.ConclusionsCOPD-related anxiety symptoms was reduced after PR, potentially through the use of various management strategies. The strategies appeared to be influenced by interactional factors during the PR program

VII Scandinavian Copd Research Symposium, Holmenkollen, Oslo 18th-19th November 2016

Peer reviewe

Data from: Efficacy of psychosocial interventions for psychological and pregnancy outcomes in infertile women and men: a systematic review and meta-analysis

Objective: To evaluate the evidence on the efficacy of psychosocial interventions for improving pregnancy rates and reducing distress for couples in treatment with assisted reproductive technology (ART). Design: Systematic review and meta-analysis. Data sources PsycINFO, PubMed, Embase, CINAHL, Web of Science and The Cochrane Library between 1978 and April 2014. Study selection Studies were considered eligible if they evaluated the effect of any psychosocial intervention on clinical pregnancy and/or distress in infertile participants, used a quantitative approach, and were published in English. Data extraction Study characteristics and results were extracted and the methodological quality assessed. Effect sizes (Hedges g) were pooled using a random effect model. Heterogeneity was assessed using the Q statistic and I2, and publication bias evaluated using Eggers’ method. Possible moderators and mediators were explored with meta-ANOVAs and meta-regression. Results We identified 39 eligible studies (total N = 2746 men and women) assessing the effects of psychological treatment on pregnancy rates and/or adverse psychological outcomes, including depressive symptoms, anxiety, infertility stress, and marital function. Statistically significant and robust overall effects of psychosocial intervention were found for both clinical pregnancy (RR = 2.01; CI: 1.48-2.73; p<0.001) and combined psychological outcomes (Hedges g=0.59; CI: 0.38-0.80; p=0.001,). The pooled effect sizes (ES) for psychological outcomes were generally larger for women (g: 0.51-0.73) than men (0.13-0.34), but the difference only reached statistical significance for depressive symptoms (p=0.004). Meta-regression indicated that larger reductions in anxiety were associated with greater improvement in pregnancy rates (Slope: 0.19; p=0.004). No clear-cut differences were found between effects of cognitive behavioral therapy (CBT) (g=0.84), mind-body interventions (0.61), and other intervention types (0.50). Conclusion The present meta-analysis suggests that psychosocial interventions for couples in treatment for infertility, in particular CBT, could be efficacious, both in reducing psychological distress and in improving clinical pregnancy rates

Search history v7

Search history v

Figure 1 PRISMA flowchart

Figure 1 PRISMA flowchar