• Title/Summary/Keyword: Non-pharmacological interventions

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Effects of Non-pharmacological Interventions on Primary Insomnia in Adults Aged 55 and Above: A Meta-analysis (수면장애가 있는 중장년 환자에게 적용한 비약물적 중재의 효과: 메타분석)

  • Kim, Ji Hyun;Oh, Pok Ja
    • Korean Journal of Adult Nursing
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    • v.28 no.1
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    • pp.13-29
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    • 2016
  • Purpose: This study was performed to evaluate the effects of non-pharmacological interventions on sleep disturbance amongst adults aged 55 and above. Methods: PubMed, Cochrane Library, EMBASE, CINAHL and several Korean databases were searched. The main search strategy combined terms including non-pharmacological interventions and presence of insomnia. Non-pharmacological interventions included cognitive behavioral therapy, auricular acupuncture, aromatherapy, and emotional freedom techniques. Methodological quality was assessed using Cochrane's Risk of Bias for randomized studies and Risk of Bias Assessment tool for non randomized studies. Data were analyzed by the RevMan 5.3 program of Cochrane Library. Results: Sixteen clinical trials met the inclusion criteria with a total of 962 participants. Non-pharmacological interventions was conducted for a mean of 5.5 weeks, 7.7 sessions, and an average of 70 minutes per session. The effects of non-pharmacological interventions on sleep quality (ES=-1.18), sleep efficiency (ES=-1.14), sleep onset latency (ES=-0.88), awakening time after sleep onset (ES=-0.87), and sleep belief (ES=-0.71) were significant, and their effect sizes were ranged from moderate to large. However, the effects on total sleep time and insomnia severity were not significant. Conclusion: The findings of the current study suggest that non-pharmacological interventions have a positive impact on attitudes and beliefs about sleep, sleep quality, sleep duration, and sleep efficiency. Therefore, the findings of the study provide an evidence to incorporate various non-pharmacological interventions into nursing practice to improve both sleep quality and quantity in patients with insomnia.

The effects of non-pharmacological interventions for adults with eating disorders: A systematic review and meta-analysis (섭식장애에서 비약물적 중재의 효과: 체계적 문헌고찰 및 메타분석)

  • Yun, So Hyeon;Kim, Gaeun
    • Korean Journal of Health Education and Promotion
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    • v.35 no.5
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    • pp.35-45
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    • 2018
  • Objectives: Despite the importance of Non-pharmacological interventions for Eating Disorders, no meta-analysis providing definite conclusions in this field has been reported. The purpose of the this study was to conduct meta-analysis of Non-pharmacological interventions for the improvement of eating disorders. Methods: We searched the Koreamed, KISTI, KMBASE, RISS and KISS and so on up to October 2017 using search terms such as ((Eating disorders OR anorexia OR binge) AND (Mediation OR program OR treatment OR therapy OR technique)) in Korean. Results: Initial searches yielded 602 citations. Of these results, seven met selection criteria. Interventions reduced the risk of binge eating disorder (standardised mean difference [SMD] -2.133, 95% CI -3.107~-1.159). Interventions reduced drive for leanness (-1.857, -3.143~-0.571), body dissatisfaction (-1.357, -2.238~-0.477), depression (-0.745, -1.298~-0.192), but not physical function (0.191, -0.089~0.471). Conclusions: The results from this study indicate that Non-pharmacological Interventions may help Eating disorders' binge eating, drive for thinness, body dissatisfaction, depression. However, larger-scale studies are needed to confirm this conclusion.

The Effects of Non-pharmacological Interventions on Sleep among Older Adults in Korean Long-term Care Facilities: A Systematic Review and Meta-analysis

  • Jung, Sun Ok;Kim, Hyeyoung;Choi, Eunju
    • Research in Community and Public Health Nursing
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    • v.33 no.3
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    • pp.340-355
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    • 2022
  • Purpose: This study aimed to examine the effects of non-pharmacological sleep intervention programs in improving sleep quality among older adults in long-term care facilities. Methods: A literature search and selection was performed on nine different databases using the guidelines of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Overall, 14 studies met the inclusion criteria and were systematically reviewed. For the meta-analysis, the effect size was estimated using the random-effects model in Review Manager (RevMan) desktop version 5.4 of the Cochrane Library. Results: The meta-analysis of overall non-pharmacological interventions obtained a total effect size of 1.0 (standardized mean difference [SMD]=1.0, 95% confidence interval [CI]: 0.64~1.35), which was statistically significant (Z=5.55, p<.001). The most frequently studied non-pharmacological intervention was aroma therapy, with an effect size of 0.61 (SMD=0.61, 95% CI: 0.14~1.08), which was statistically significant (Z=2.55, p=.010). In the subgroup analysis, group-based interventions, interventions for >4 weeks, and untreated control studies were more effective. Conclusion: This study confirms that non-pharmacological interventions are effective in improving sleep quality among older adults in long-term care facilities. However, the sample size was small and the risk of bias in assessing the interventions of individual studies was unclear or high, thereby limiting the generalizability of the results. Further reviews that evaluate randomized control trials, evidence-based interventions that consider older adult participants' physical activity levels, different intervention methods and durations, and different control group intervention types are needed to obtain more conclusive evidence.

Non-Pharmacological Interventions to Relieve Labor Pain: A Literature Review (비약물적 분만통증 중재법에 대한 고찰)

  • Kim, Jeong-Soo
    • Korean Parent-Child Health Journal
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    • v.14 no.1
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    • pp.28-35
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    • 2011
  • Purpose: The aim of this study is to suggest a direction for the development of effective methods for relieving labor pain, by analyzing non-pharmacological interventions through a literature review. Methods: Collection of literature data in this study has been accomplished through theses, reports, and academic data searched on databases of the Research Information Sharing Services (Riss), PubMed, ProQuest, and the National Discovery for Science Leaders (NDSL). Results: Non-pharmacological interventions analyzed as effective in relieving labor pain, in literature published both within and outside of Korea, included: pre-delivery education, Yoga, Doula delivery care, Massage, Music therapy, Aromatherapy, Hypnosis, TENS, Sterilized water injection, and Acupuncture. Conclusion: Several different interventions have been attempted for the relief of labor pain. Since even the same intervention shows different results depending on the research method utilized, critical factors must be acknowledged that compromise the effectiveness of these methods. In addition, study of potential synergy effects of interventions that combine these various methods might also prove to be significant.

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Effects of Non-Pharmacological Interventions on Major Adverse Cardiac Events in Patients Underwent Percutaneous Coronary Intervention: Systematic Review and Meta-Analysis (경피적 관상동맥 중재술을 시행한 대상자에게 적용한 비약물적 중재가 주요 심혈관 사건에 미치는 효과: 체계적 문헌고찰과 메타분석)

  • Jo, Sojeong;Lee, Haejung;Park, Gaeun
    • Journal of Korean Academy of Nursing
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    • v.54 no.3
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    • pp.311-328
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    • 2024
  • Purpose: In this study a systematic review and meta-analysis investigated the impact of non-pharmacological interventions on major adverse cardiac events (MACE) in patients with coronary artery disease who underwent percutaneous coronary intervention (PCI). Methods: A literature search was performed using PubMed, Cochrane Library, EMBASE, and Cumulative Index to Nursing & Allied Health Literature databases up to November 2023. The risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool. Effect sizes and 95% confidence intervals were calculated using R software (version 4.3.2). Results: Eighteen randomized studies, involving 2,898 participants, were included. Of these, 16 studies with 2,697 participants provided quantitative data. Non-pharmacological interventions (education, exercise, and comprehensive) significantly reduced the risk of angina, heart failure, myocardial infarction, restenosis, cardiovascular-related readmission, and cardiovascular-related death. The subgroup meta-analysis showed that combined interventions were effective in reducing the occurrence of myocardial infarction (MI), and individual and group-based interventions had significant effects on reducing the occurrence of MACE. In interventions lasting seven months or longer, occurrence of decreased by 0.16 times, and mortality related to cardiovascular disease decreased by 0.44 times, showing that interventions lasting seven months or more were more effective in reducing MI and cardiovascular disease-related mortality. Conclusion: Further investigations are required to assess the cost-effectiveness of these interventions in patients undergoing PCI and validate their short- and long-term effects. This systematic review underscores the potential of non-pharmacological interventions in decreasing the incidence of MACE and highlights the importance of continued research in this area (PROSPERO registration number: CRD42023462690).

Brain-Derived Neurotrophic Factor and Brain Plasticity: Non-Pharmacological Intervention (뇌유래신경영양인자와 뇌 신경가소성: 비약물적 개입)

  • Nak-Young Kim;Hyun Kook Lim
    • Korean Journal of Biological Psychiatry
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    • v.30 no.1
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    • pp.1-6
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    • 2023
  • Many psychiatric disorders are associated with brain functional dysfunctions and neuronal degeneration. According to the research so far, enhanced brain plasticity reduces neurodegeneration and recovers neuronal damage. Brain-derived neurotrophic factor (BDNF) is one of the most extensively studied neurotrophins in the mammalian brain that plays major roles in neuronal survival, development, growth, and maintenance of neurons in brain circuits related to emotion and cognitive function. Also, BDNF plays an important role in brain plasticity, influencing dendritic spines in the hippocampus neurogenesis. Changes in neurogenesis and dendritic density can improve psychiatric symptoms and cognitive functions. BDNF has potent effects on brain plasticity through biochemical mechanisms, cellular signal pathways, and epigenetic changes. There are pharmacological and non-pharmacological interventions to increase the expression of BDNF and enhance brain plasticity. Non-pharmacological interventions such as physical exercise, nutritional change, environmental enrichment, and neuromodulation have biological mechanisms that increase the expression of BDNF and brain plasticity. Non-pharmacological interventions are cost-effective and safe ways to improve psychiatric symptoms.

A Systematic Review and Meta-analysis on the Effect of Delirium Prevention Intervention in Korean Intensive Care Units (국내 중환자실 섬망 예방 중재에 관한 체계적 고찰 및 메타분석)

  • Kang, Jiyeon;Choi, Min Jeong
    • Journal of Korean Critical Care Nursing
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    • v.14 no.3
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    • pp.141-156
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    • 2021
  • Purpose : This study aimed to systematically review the preventive interventions for delirium in Korean intensive care unit (ICU) patients and evaluate their efficacy. Methods : For this systematic review and meta-analysis, we searched the literature and selected studies from data sources that included the RISS, KISS, National Central Library, National Assembly Library, DBpia, Science on, MEDLINE, and Cochrane Library. We used Cochrane's revised tool for risk of bias in randomized trials and non-randomized studies of intervention tools to assess the quality of the selected studies. The effect size of the intervention was calculated as odds ratio (OR) and standardized mean difference (SMD). Results : Preventive interventions reported in 23 studies with a total of 4,799 ICU patients were effective in reducing the occurrence of delirium (OR=0.64, 95% CI : 0.49~0.91, p=.011), but not the duration (SMD=-0.22, 95% CI : -0.51~0.08, p=.148). As a result of a subgroup analysis, non-pharmacological interventions were effective in reducing the occurrence of delirium (OR=0.66, 95% CI : 0.47~0.94, p=.020), while pharmacological interventions had no effect (OR=0.68, 95% CI : 0.33~1.40, p=.295). Among the non-pharmacological interventions, multi-component intervention had the largest effect size (OR=0.38, 95% CI : 0.26~0.55, p<.001). Conclusion : Non-pharmacological interventions were effective in reducing the occurrence of delirium. We recommend the development and application of multi-component interventions to prevent delirium in the Korean ICU patients.

The Analysis of Non-pharmacological Intervention Study for Nonalcoholic Fatty Liver Disease: Intervention Types and Measurement Parameters (비알코올성 지방간질환에 대한 이해와 비약물적 중재 및 측정지표에 대한 문헌분석)

  • Kim, Na Hyun
    • Journal of Korean Biological Nursing Science
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    • v.15 no.2
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    • pp.43-53
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    • 2013
  • Purpose: This study was intended to analyze the types and measurement parameters of non-pharmacological interventional studies for nonalcoholic fatty liver disease (NAFLD). Methods: NAFLD related literatures were systematically reviewed. The existing literatures were searched electronically using the data base of PubMed, a Medline data base of the National Library of Medicine with the key words of nonalcoholic fatty liver disease, NAFLD, nonalcoholic steatohepatitis, and NASH. The criteria for inclusion in this review were 1) non-pharmacological intervention, 2) human, 3) English. Finally, 20 articles were included in the review. Results: The major findings of this study were as follows: 1) the types of non-pharmacological intervention were exercise (35%), caloric restriction (30%), and lifestyle modification with combination both of exercise and caloric restriction (35%), 2) Almost all studies adopted various measurement parameters derived from pathophysiological mechanism-based biomarkers such as anthropometric indices, biochemical parameters, body fat mass, and liver biopsy results. Conclusion: Non-pharmacological interventions have been reported to be effective to improve NAFLD status, and many objective biomarkers confirmed supported these findings. Therefore, the development of nursing interventions for NAFLD subjects is needed and the consideration of using mechanism-based biomarkers is suggested to verify nursing outcomes objectively.

Non-Pharmacological Interventions for Behavioral and Psychological Symptoms of Neurocognitive Disorder (신경인지장애의 정신행동증상에 대한 비약물학적 개입)

  • Hyun Kim;Kang Joon Lee
    • Korean Journal of Psychosomatic Medicine
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    • v.31 no.1
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    • pp.1-9
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    • 2023
  • Patients with neurocognitive disorder show behavioral psychological symptoms such as agitation, aggression, depression, and wandering, as well as cognitive decline, which puts a considerable burden on patients and their families. For the treatment of behavioral psychological symptoms, patient-centered, non-pharmacological treatment should be used as a first line approach. This paper describes non-pharmacological interventions to manage and treat behavioral psychological symptoms in patients with neurocognitive disorder. In order to control behavioral psychological symptoms such as agitation, depression, apathy, insomnia, and wandering, it is important to identify and evaluate factors such as environmental changes and drugs, and then solve such problems. Non-pharmacological interventions include reassurance, encourage, distraction, and environmental change. It is necessary to understand behavior from a patient's point of view and to approach the patient's needs and abilities appropriately. Reminiscence therapy, music therapy, aroma therapy, multisensory stimulation therapy, exercise therapy, light therapy, massage therapy, cognitive intervention therapy, and pet therapy are used as non-pharmacological interventions, and these approaches are known to improve symptoms such as depression, apathy, agitation, aggression, anxiety, wandering, and insomnia. However, the quality of the evidence base for non-pharmacological approaches is generally lower than for pharmacological treatments. Therefore, more extensive and accurate effectiveness verification studies are needed in the future.

Research Trends in Non-Pharmacological Interventions for Physical Rehabilitation after Breast Cancer Treatment: A scoping review (유방암 치료 후 신체 재활을 위한 비약물적 중재의 연구 동향 : 주제범위 문헌고찰)

  • Jeong-Woo Lee;Tae-Hwa Seo
    • Journal of The Korean Society of Integrative Medicine
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    • v.12 no.3
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    • pp.101-120
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    • 2024
  • Purpose : This study aimed to carry out a scoping review to investigate the research trends in non-pharmacological interventions for physical rehabilitation following breast cancer treatment. Methods : A scoping review was conducted according to the five steps outlined by Arksey and O'Malley and PRISMA-ScR. We searched three domestic databases (ScienceOn, Riss, KCI) and two international databases (PubMed, Cochrane Central) between January 2014 and April 2024. The keywords used were 'breast cancer surgery', 'breast cancer treatment', 'breast cancer lymphedema', 'intervention', 'management', 'therapy', 'disorder', and 'dysfunction'. Results : In terms of publication, the number of studies in the past five years has increased compared to the previous five years, with most studies focusing on patients aged 41 to 60 and who underwent surgical treatment for breast cancer. A total of 43 different types of non-pharmacological interventions were applied: 21 single interventions and 22 combination interventions. Among the intervention methods, complete decongestive treatment (CDT), resistance training, and manual lymphatic drainage were the most frequently utilized. The most common duration of intervention turned out to be 4~5 weeks and more than 8 weeks, with frequencies of 2~3 sessions per week and more than 4 sessions per week. The most frequently used dependent variables included range of motion (ROM) and disabilities of the arm, shoulder and hand (DASH) for the function and disorder of the upper limb category; arm circumference or volume and bio-impedance for the lymphedema category; visual analogue scale (VAS) and numerical rating scale (NRS) for the pain category; and the European organization for research and treatment of cancer quality of life questionnaire breast cancer module (EORTC QLQ) and functional assessment of cancer therapy-breast (FACT-B) for the quality of life category. Conclusion : The findings of this scoping review provide valuable mapping data for non-pharmacological interventions for physical rehabilitation following breast cancer treatment. We recommend further research, particularly systematic reviews and meta-analyses, to build upon these findings.