Healthy Lifestyle Interventions in General Practice. Part 3: Lifestyle and Chronic Respiratory Disease

Chronic respiratory diseases, in particular chronic obstructive pulmonary disease (COPD), can be classified as a part of the chronic diseases of lifestyle. A lifestyle intervention programme is therefore an essential component of the non-pharmacological management of COPD and other chronic respiratory diseases. The main indication for referral to a lifestyle intervention programme is any symptomatic patient with either COPD or any other chronic respiratory disease, and who also has limited functional capacity. Following a comprehensive initial assessment, patients are recommended to attend either a group-based programme (medically supervised or medically directed, depending on the severity of the disease and the presence of any co-morbidities) or a home-based intervention programme. The main elements of the intervention programme are smoking cessation, exercise training (minimum of three times per week), education, psychosocial support and nutritional support. Regular monitoring should be conducted during training sessions, and a follow-up assessment is indicated after 2-3 months to assess progress and to re-set goals. Longer-term (56 months) intervention programmes are associated with better long-term outcomes. South African Family Practice Vol. 50 (6) 2008: pp. 6-

Healthy lifestyle interventions in general practice: Part 15: Lifestyle and lower back pain

Lower back pain (LBP) is one of the most common medical problems in the adult population. LBP can be defined as pain, muscle tension or stiffness that is localised below the costal margin (inferior rib cage) and above the inferior gluteal folds and that can present either with or without leg pain (sciatica), and it can be classified as “specific” or “non-specific”. LBP has a high lifetime prevalence and is associated with a substantial direct and indirect cost to the individual and society. In this review, the focus is on the identification of lifestyle risk factors and interventions that are associated with mainly non-specific chronic LBP. In addition to pharmacotherapy, the best treatment approach is exercise therapy (including physical reconditioning), psychosocial and behavioural intervention and therapeutic education. Other lifestyle changes include nutritional intervention and smoking cessation

Healthy lifestyle interventions in general practice. Part 2: Lifestyle and cardiovascular disease

This article forms the second part of the series on the role of lifestyle modification in general practice with specific reference to chronic cardiovascular disease. Whilst the major risk factors which constitute an unhealthy lifestyle were discussed in part 1 of this series, the focus of part 2 will give specific practical guidelines which the general practitioner may incorporate into their practice when counselling patients with chronic cardiovascular disease

Healthy lifestyle interventions in general practice: Part16: Lifestyle and fibromyalgia

Fibromyalgia is a chronic disorder, characterised by chronic widespread musculoskeletal pain, and the presence of multiple tender points as well as a host of associated symptomatology. Optimal management of patients with fibromyalgia requires a multidisciplinary approach, with a combination of pharmacological and non-pharmacological interventions that are tailored to the patient's pain, dysfunction and associated features, including depression, sleep disorder and fatigue. Non-pharmacological lifestyle-based interventions to treat this disorder include exercise therapy, dietary modification, and psychosocial interventions. This review outlines these three forms of lifestyle intervention in patients with fibromyalgia

Healthy lifestyle interventions in general practice Part 4: Lifestyle and diabetes mellitus

Diabetes mellitus, in particular Type 2 diabetes, can be classified as a chronic disease of lifestyle. A lifestyle intervention programme is therefore an essential component of the primary and secondary prevention (management) of diabetes mellitus. The main indication for referral to a lifestyle intervention programme is any patient with either pre-diabetes or established diabetes mellitus. Following a comprehensive initial assessment, patients are recommended to attend either a group-based programme (medically supervised or medically directed, depending on the severity of the disease and the presence of any co-morbidities) or a home-based intervention programme. The main elements of the intervention programme are nutritional intervention, exercise training (minimum of 150 minutes at moderate intensity per week), psychosocial support and education. Regular monitoring should be conducted during training sessions, and a follow-up assessment is indicated after 2–3 months to assess progress and to re-set goals. Longer-term (5–6 months) intervention programmes are associated with better long-term outcomes

Healthy lifestyle interventions in general practice Part 10: Lifestyle and arthritic conditions - Osteoarthritis

Chronic musculoskeletal disease is one of the most common causes of disability worldwide with considerable economic impact in health care. Osteoarthritis (OA) is the most common chronic musculoskeletal disease affecting a large proportion of the population with an increasing predicted prevalence in the next two decades. Regular physical exercise, nutritional intervention, psychological support and other lifestyle interventions are very important components of the nonpharmacological management of patients with OA. The main rationale to include regular exercise as part of a lifestyle intervention programme for OA is to improve muscle strength and proprioception, and to promote the other general health benefits of participating in regular physical activity. Nutritional intervention should focus on weight reduction while basic nutrients that are required for healthy joints should be provided. Glucosamine and chondroitin supplemention is commonly used and may reduce pain, improve function and reduce or arrest disease progression. Psychological intervention has a particular role in assisting with pain management

Healthy lifestyle interventions in general practice Part 13: Lifestyle and osteoporosis

Osteoporosis is defined as a systemic skeletal disease that is characterised by low bone mass and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fractures. Therefore, the diagnosis of osteoporosis is based on measurement of bone mineral density (BMD) using central (axial) dual energy X-ray absorptiometry (DXA), and clinical evidence of a fragility fracture (history or radiological evidence). Osteoporosis is a major public health problem, affecting about 30% of postmenopausal women of Caucasian origin, and 70% of those aged 80 years. The risk factors for osteoporosis include lifestyle factors, genetic/ethnic factors, specific diseases causing secondary osteoporosis, ageing factors, qualitative factors, and drugs that are toxic to bone. In addition, there are specific additional risk factors for falls that need to be considered. It is well established that lifestyle factors, including physical activity, nutritional intervention, psychosocial intervention, smoking cessation and other lifestyle factor interventions are key elements in the prevention and management of osteoporosis. Guidelines for these lifestyle interventions in the prevention and management of osteoporosis are reviewed

Examining the effects of a mindfulness-based professional training module on mindfulness, perceived stress, self-compassion and self-determination

CITATION: Whitesman, S. & Mash, R. 2015. Examining the effects of a mindfulness-based professional training module on mindfulness, perceived stress, self-compassion and self-determination. African Journal of Health Professions Education, 7(2):220-223, doi:10.7196/AJHPE.460.The original publication is available at http://www.ajhpe.org.zaBackground. Mindfulness-based interventions (MBIs) have been shown to be effective in a wide range of health-related problems. Teaching and research with regard to MBIs have largely been conducted in the USA and Europe. The development of teachers of MBIs requires that they embody the practice of mindfulness and acquire pedagogical competencies. Stellenbosch University and the Institute for Mindfulness South Africa have launched a new and innovative training programme consisting of 4 modules, with a blend of residential retreats and e-learning. Internationally, this is the first study that specifically investigates the effects of mindfulness on the mental state of health professionals being trained to teach MBIs in their clinical practice. Objectives. To evaluate the first 9-week module in terms of its effect on mindfulness practice, self-determination, self-compassion and perception of stress. Methods. This is a before-and-after study of 23 participants, using 4 validated tools: Kentucky Inventory of Mindfulness Skills, Self-Determination Scale, Self-Compassion Scale, Perceived Stress Scale. Results. There were significantly increased scores (p<0.05) for all 4 aspects of mindfulness practice (observing, describing, acting with awareness and accepting without judgement) and self-compassion. There was also a significant decrease in the perception of stress, but no effect on self-determination scores, which were already high at baseline. Conclusion. Potential teachers of MBIs in South Africa demonstrated significant gains in their own mindfulness practice and self-compassion as well as decreased perception of stress during the first module of the training programme. Further research will follow as this group completes the entire programme.http://www.ajhpe.org.za/index.php/ajhpe/article/view/460Publisher's versio