An integrative healthcare model with heartfulness meditation and care coordination improves outcomes in cyclic vomiting syndrome

被引:8
|
作者
Venkatesan, Thangam [1 ]
Porcelli, Anthony [2 ]
Matapurkar, Anagha [3 ]
Kumar, Vishnu Charan Suresh [1 ]
Szabo, Aniko [4 ]
Yin, Ziyan [4 ]
Wieloch, Laura [5 ]
机构
[1] Med Coll Wisconsin, Dept Med, Div Gastroenterol & Hepatol, Milwaukee, WI 53226 USA
[2] Marquette Univ, Dept Psychol, Milwaukee, WI 53233 USA
[3] Heartfulness Inst, Austin, TX USA
[4] Med Coll Wisconsin, Inst Hlth & Equ, Milwaukee, WI 53226 USA
[5] Froedtert Hosp, Milwaukee, WI USA
来源
NEUROGASTROENTEROLOGY AND MOTILITY | 2021年 / 33卷 / 11期
基金
美国国家卫生研究院;
关键词
care coordination; cyclic vomiting; heartfulness meditation; integrative medicine;
D O I
10.1111/nmo.14132
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background Cyclic vomiting syndrome (CVS) is associated with psychosocial comorbidity and often triggered by stress. Since the current disease-centered care model does not address psychosocial factors, we hypothesized that holistic, patient-centered care integrating meditation and addressing psychosocial needs through a care coordinator will improve healthcare outcomes in CVS. Methods We conducted a prospective randomized controlled trial: 49 patients with CVS (mean age: 34 +/- 14 years; 81% female) were randomized to conventional health care (controls) or Integrative Health care (IHC) (27: controls, 22: IHC). The IHC group was assigned a care coordinator and received meditation with a certified instructor. Outcomes including psychological distress, coping strategies to manage chronic stress, cognitive symptom management, and Health-Related Quality of Life (HRQoL) were measured. Key Results In intention-to-treat analyses, patients receiving IHC showed significant improvement in multiple domains of coping including positive reframing, planning, and reduction in self-blame (p values <= 0.05), and physical HRQoL (p = 0.03) at 6 months. They also leaned toward spirituality/religion as a coping measure (p <= 0.02 at 3 and 6 months). Subgroup analysis of compliant patients showed additional benefit with significant reduction in psychological distress (p = 0.04), improvement in sleep quality (p = 0.03), reduction in stress levels (0.02), improvement in physical HRQoL (0.04), and further improvement in other domains of coping (p < 0.05). Conclusions and Inferences An IHC model incorporating meditation and care coordination improves patient outcomes in CVS and is a useful adjunct to standard treatment. Studies to determine the independent effects of meditation and care coordination are warranted.
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页数:11
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