Esch, Tobias

Fricchione, Gregory L.

Joos, Stefanie

Teut, Michael

Evidence-based Complementary and Alternative Medicine

Harvard University - DASH 

 Self-Care, Stress Management, and Primary Care: FromSalutogenesis and Health Promotion to Mind-Body Medicine  (Article begins on next page)The Harvard community has made this article openly available.Please share how this access benefits you. Your story matters.Citation Esch, Tobias, Gregory L. Fricchione, Stefanie Joos, and MichaelTeut. 2013. “Self-Care, Stress Management, and Primary Care:From Salutogenesis and Health Promotion to Mind-BodyMedicine.” Evidence-based Complementary and AlternativeMedicine : eCAM 2013 (1): 327415. doi:10.1155/2013/327415.http://dx.doi.org/10.1155/2013/327415.Published Version doi:10.1155/2013/327415Accessed February 19, 2015 3:28:59 PM ESTCitable Link http://nrs.harvard.edu/urn-3:HUL.InstRepos:11879905Terms of Use This article was downloaded from Harvard University's DASHrepository, and is made available under the terms and conditionsapplicable to Other Posted Material, as set forth athttp://nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of-use#LAAHindawi Publishing CorporationEvidence-Based Complementary and Alternative MedicineVolume 2013, Article ID 327415, 2 pageshttp://dx.doi.org/10.1155/2013/327415EditorialSelf-Care, Stress Management, and Primary Care: FromSalutogenesis and Health Promotion to Mind-Body MedicineTobias Esch,1,2 Gregory L. Fricchione,3 Stefanie Joos,4 and Michael Teut51 H a r v a r dM e d i c a lS c h o o la n dD i v i s i o no fG e n e r a lM e d i c i n e&P r i m a r yC a r e ,B e t hI s r a e lD e a c o n e s sM e d i c a lC e n t e r ,B o s t o n ,M A0 2 2 1 5 ,U S A2Division of Integrative Health Promotion, Coburg University of Applied Sciences, 96450 Coburg, Germany3Harvard Medical School and Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA4Department of General Practice and Health Services Research, Heidelberg University Hospital, 69115 Heidelberg, Germany5Institute for Social Medicine, Epidemiology and Health Economics, Charit´ e-University Medicine, Berlin, 10117 Berlin, GermanyCorrespondence should be addressed to Tobias Esch; tesch@bidmc.harvard.eduReceived 8 December 2013; Accepted 8 December 2013Copyright © 2013 Tobias Esch et al. This is an open access article distributed under the Creative Commons Attribution License,which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Stress is a major concern in medicine and the social andhealth sciences nowadays. In fact, not only are stress-associated ailments and diseases rapidly growing, that is,virtually everywhere in the modern world, but also thecost of treatment and “collateral damage,” for example, inoccupational health or the economy as a whole, seems toincrease exponentially—for example, see [1, 2]. This may bedue to a more recent phenomenon called “burn-out”; how-ever,thereisclearevidencethatmyocardialinfarction,stroke,depression, anxiety, and even some disease-prone immuneprocesses, including proinflammation as a common diseasedenominator that is critically associated with stress [3], arecontinuously gaining recognition in medicine and bear clearrelation upon stress and its (patho)physiology [4]. Thus,preventive and therapeutic options to reduce and preventstress and, simultaneously, improve stress management skillsare strongly needed. Mindfulness-based programs and othermind-body medical and cognitive behavioral strategies to(better) deal with stress are taught and evaluated at manyplaces, including academic medical sites and universities[5]; however, their outcome is usually measured in termsof clinical improvements with disease states, inhibition ofdisease progression, or cure and relapse prevention.Since primary care and health promotion can be seenas the first line of defense in medicine and, yet, as setting-oriented “places” where resistance resources, health protec-tion,resiliency,andsalutogenesisarefacilitatedinmorecom-plex situations and modalities, it should and will incorporateself-care-oriented means, techniques, and strategies to lowerstress at all levels and improve self- or stress managements k i l l so ft h ep o p u l a t i o na saw h o l e — a n do fe a c hs i n g l eindividual under treatment. Research in this area is evolvinganditfocusesonthemanyaspectsthatcontributetoahealthyand more stress-resilient life-style, hence, looking not only attangiblediseaseoutcomesbutalsoatqualityoflife,happiness,flourishing, subjective well-being, optimism, and so on—forexample, see [6].With this special issue, we invited investigators to con-t r i b u t eo r i g i n a lr e s e a r c ha sw e l la sr e v i e wa r t i c l e st h a tc o u l dstimulate the continuing efforts to understand the molecu-lar, (patho)physiological, neurobiological, and, particularly,clinical factors that underlie stress and stress managementprograms or related interventions. Furthermore, we wereinterestedinarticlesthatfocusedonanymind-bodymedical,CAM, cognitive behavioral, or mindfulness-based techniquethat is believed or said to alleviate stress and the negativeoutcomesofitsburden,thatis,examiningtheseinterventionsinclinicalorout-patientandsetting-orientedareas,includingwork-place, occupational and communal health, and, espe-cially of interest, primary care.As expected, we received a broad array of papers andwere able, following rigorous review procedures, to accepta couple of them that still cover the whole picture wehad originally thought of. Papers on the effectiveness of ahappiness training (positive psychology intervention) or onp r o g r e s s i v em u s c l er e l a x a t i o n( P M R )d u r i n gl u n c hb r e a k s2 Evidence-Based Complementary and Alternative Medicinein the field of occupational health are now included, asare studies on the applicability and effectiveness of mind-body interventions and more complex programs, includingmindfulness-based approaches or self-compassion training,in depression, in anxiety, or in general distress. Varioussettings are depicted, including the military or school andeducation. Finally, a focus lies on salutogenesis and resource-orientation in general practice.We hope this special issue meets the expectations of itsreaders,asitpositivelyexceededoursaseditors.Wearehappyto herewith launch this special issue and open the discussionon the aspects raised.Tobias EschGregory L. FricchioneStefanie JoosMichael TeutReferences[1] M. Kalia, “Assessing the economic impact of stress—the mod-erndayhiddenepidemic,”Metabolism,vol.51,no.6,supplement1 ,p p .4 9 – 5 3 ,2 0 0 2 .[ 2 ]J .B .C r o ft ,A .H .M o k d a d ,A .K .P o w e r ,K .J .G r e e n l u n d ,a n dW.H.Giles,“Publichealthsurveillanceofseriouspsychologicaldistress in the United States,” International Journal of PublicHealth,v o l .5 4 ,n o .1 ,s u p p l e m e n t ,p p .4 – 6 ,2 0 0 9 .[3] T. Esch and G. B. Stefano, “Proinflammation: a commondenominatororinitiatorofdifferentpathophysiologicaldiseaseprocesses,” Medical Science Monitor,v o l .8 ,n o .5 ,p p .1 – 9 ,2 0 0 2 .[4] A. Rosengren, S. Hawken, S. ˆ Ounpuu et al., “Association ofpsychosocial risk factors with risk of acute myocardial infarc-tion in 11 119 cases and 13 648 controls from 52 countries (theINTERHEARTstudy):case-controlstudy,”TheLancet,vol.364,no. 9438, pp. 953–962, 2004.[5] A. L. Komaroff, Mind-Body Medicine: A Special Health Report,Harvard Health Publications, Harvard Medical School, Boston,Mass, USA, 2001.[ 6 ]C .S .C a r v e r ,M .F .S c h e i e r ,a n dS .C .S e g e r s t r o m ,“ O p t i m i s m , ”Clinical Psychology Review,v o l .3 0 ,n o .7 ,p p .8 7 9 – 8 8 9 ,2 0 1 0 .

Self-Care, Stress Management, and Primary Care: From Salutogenesis and Health Promotion to Mind-Body Medicine

Tobias Esch

Gregory L. Fricchione

Stefanie Joos

Michael Teut

Directory of Open Access Journals

Crossref

Hindawi Publishing CorporationEvidence-Based Complementary and Alternative MedicineVolume 2013, Article ID 327415, 2 pageshttp://dx.doi.org/10.1155/2013/327415EditorialSelf-Care, Stress Management, and Primary Care: FromSalutogenesis and Health Promotion to Mind-Body MedicineTobias Esch,1,2 Gregory L. Fricchione,3 Stefanie Joos,4 and Michael Teut51 Harvard Medical School and Division of General Medicine & Primary Care, Beth Israel Deaconess Medical Center,Boston, MA 02215, USA2Division of Integrative Health Promotion, Coburg University of Applied Sciences, 96450 Coburg, Germany3Harvard Medical School and Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA4Department of General Practice and Health Services Research, Heidelberg University Hospital, 69115 Heidelberg, Germany5 Institute for Social Medicine, Epidemiology and Health Economics, Charite´-University Medicine, Berlin, 10117 Berlin, GermanyCorrespondence should be addressed to Tobias Esch; tesch@bidmc.harvard.eduReceived 8 December 2013; Accepted 8 December 2013Copyright © 2013 Tobias Esch et al. This is an open access article distributed under the Creative Commons Attribution License,which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Stress is a major concern in medicine and the social andhealth sciences nowadays. In fact, not only are stress-associated ailments and diseases rapidly growing, that is,virtually everywhere in the modern world, but also thecost of treatment and “collateral damage,” for example, inoccupational health or the economy as a whole, seems toincrease exponentially—for example, see [1, 2]. This may bedue to a more recent phenomenon called “burn-out”; how-ever, there is clear evidence thatmyocardial infarction, stroke,depression, anxiety, and even some disease-prone immuneprocesses, including proinflammation as a common diseasedenominator that is critically associated with stress [3], arecontinuously gaining recognition in medicine and bear clearrelation upon stress and its (patho)physiology [4]. Thus,preventive and therapeutic options to reduce and preventstress and, simultaneously, improve stress management skillsare strongly needed. Mindfulness-based programs and othermind-body medical and cognitive behavioral strategies to(better) deal with stress are taught and evaluated at manyplaces, including academic medical sites and universities[5]; however, their outcome is usually measured in termsof clinical improvements with disease states, inhibition ofdisease progression, or cure and relapse prevention.Since primary care and health promotion can be seenas the first line of defense in medicine and, yet, as setting-oriented “places” where resistance resources, health protec-tion, resiliency, and salutogenesis are facilitated inmore com-plex situations and modalities, it should and will incorporateself-care-oriented means, techniques, and strategies to lowerstress at all levels and improve self- or stress managementskills of the population as a whole—and of each singleindividual under treatment. Research in this area is evolvingand it focuses on themany aspects that contribute to a healthyand more stress-resilient life-style, hence, looking not only attangible disease outcomes but also at quality of life, happiness,flourishing, subjective well-being, optimism, and so on—forexample, see [6].With this special issue, we invited investigators to con-tribute original research as well as review articles that couldstimulate the continuing efforts to understand the molecu-lar, (patho)physiological, neurobiological, and, particularly,clinical factors that underlie stress and stress managementprograms or related interventions. Furthermore, we wereinterested in articles that focused on anymind-bodymedical,CAM, cognitive behavioral, or mindfulness-based techniquethat is believed or said to alleviate stress and the negativeoutcomes of its burden, that is, examining these interventionsin clinical or out-patient and setting-oriented areas, includingwork-place, occupational and communal health, and, espe-cially of interest, primary care.As expected, we received a broad array of papers andwere able, following rigorous review procedures, to accepta couple of them that still cover the whole picture wehad originally thought of. Papers on the effectiveness of ahappiness training (positive psychology intervention) or onprogressive muscle relaxation (PMR) during lunch breaks2 Evidence-Based Complementary and Alternative Medicinein the field of occupational health are now included, asare studies on the applicability and effectiveness of mind-body interventions and more complex programs, includingmindfulness-based approaches or self-compassion training,in depression, in anxiety, or in general distress. Varioussettings are depicted, including the military or school andeducation. Finally, a focus lies on salutogenesis and resource-orientation in general practice.We hope this special issue meets the expectations of itsreaders, as it positively exceeded ours as editors.We are happyto herewith launch this special issue and open the discussionon the aspects raised.Tobias EschGregory L. FricchioneStefanie JoosMichael TeutReferences[1] M. Kalia, “Assessing the economic impact of stress—the mod-ern day hidden epidemic,”Metabolism, vol. 51, no. 6, supplement1, pp. 49–53, 2002.[2] J. B. Croft, A. H. Mokdad, A. K. Power, K. J. Greenlund, andW.H. Giles, “Public health surveillance of serious psychologicaldistress in the United States,” International Journal of PublicHealth, vol. 54, no. 1, supplement, pp. 4–6, 2009.[3] T. Esch and G. B. Stefano, “Proinflammation: a commondenominator or initiator of different pathophysiological diseaseprocesses,”Medical Science Monitor, vol. 8, no. 5, pp. 1–9, 2002.[4] A. Rosengren, S. Hawken, S. Oˆunpuu et al., “Association ofpsychosocial risk factors with risk of acute myocardial infarc-tion in 11 119 cases and 13 648 controls from 52 countries (theINTERHEART study): case-control study,”TheLancet, vol. 364,no. 9438, pp. 953–962, 2004.[5] A. L. Komaroff, Mind-Body Medicine: A Special Health Report,Harvard Health Publications, Harvard Medical School, Boston,Mass, USA, 2001.[6] C. S. Carver, M. F. Scheier, and S. C. Segerstrom, “Optimism,”Clinical Psychology Review, vol. 30, no. 7, pp. 879–889, 2010.Submit your manuscripts athttp://www.hindawi.comStem CellsInternationalHindawi Publishing Corporationhttp://www.hindawi.com Volume 2014Hindawi Publishing Corporationhttp://www.hindawi.com Volume 2014MEDIATORSINFLAMMATIONofHindawi Publishing Corporationhttp://www.hindawi.com Volume 2014Behavioural NeurologyEndocrinologyInternational Journal ofHindawi Publishing Corporationhttp://www.hindawi.com Volume 2014Hindawi Publishing Corporationhttp://www.hindawi.com Volume 2014Disease MarkersHindawi Publishing Corporationhttp://www.hindawi.com Volume 2014BioMed Research InternationalOncologyJournal ofHindawi Publishing Corporationhttp://www.hindawi.com Volume 2014Hindawi Publishing Corporationhttp://www.hindawi.com Volume 2014Oxidative Medicine and Cellular LongevityHindawi Publishing Corporationhttp://www.hindawi.com Volume 2014PPAR ResearchThe Scientific World JournalHindawi Publishing Corporation http://www.hindawi.com Volume 2014Immunology ResearchHindawi Publishing Corporationhttp://www.hindawi.com Volume 2014Journal ofObesityJournal ofHindawi Publishing Corporationhttp://www.hindawi.com Volume 2014Hindawi Publishing Corporationhttp://www.hindawi.com Volume 2014 Computational and  Mathematical Methods in MedicineOphthalmologyJournal ofHindawi Publishing Corporationhttp://www.hindawi.com Volume 2014Diabetes ResearchJournal ofHindawi Publishing Corporationhttp://www.hindawi.com Volume 2014Hindawi Publishing Corporationhttp://www.hindawi.com Volume 2014Research and TreatmentAIDSHindawi Publishing Corporationhttp://www.hindawi.com Volume 2014Gastroenterology Research and PracticeHindawi Publishing Corporationhttp://www.hindawi.com Volume 2014Parkinson’s DiseaseEvidence-Based Complementary and Alternative MedicineVolume 2014Hindawi Publishing Corporationhttp://www.hindawi.com

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Self-Care, Stress Management, and Primary Care: From Salutogenesis and Health Promotion to Mind-Body Medicine

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