Search Results (39)

Background/Objectives: Anxiety before ophthalmic surgery under local anesthesia may hinder patient cooperation and surgical outcomes. Nurse-led auditory interventions offer a promising non-pharmacological approach to perioperative anxiety management. This study evaluated the effectiveness of superimposed binaural beats (SBBs)—classical music layered with frequency differentials—in reducing anxiety during pterygium surgery with conjunctival autografting. Methods: In this randomized controlled trial, 111 adult patients scheduled for elective pterygium excision with conjunctival autografting under local anesthesia were allocated to one of three groups: SBBs, plain music (PM), or silence (control). A trained perioperative nurse administered all auditory interventions. The patients’ anxiety was assessed using the State–Trait Anxiety Inventory—State (STAI-S), and physiological parameters (blood pressure, heart rate, respiratory rate, and oxygen saturation) were recorded before and after surgery. Results: The SBB group showed significantly greater reductions in their STAI-S scores (p < 0.001), systolic blood pressure (p = 0.011), heart rate (p = 0.003), and respiratory rate (p = 0.009) compared to the PM and control groups. No adverse events occurred. Conclusions: SBBs are a safe, nurse-delivered auditory intervention that significantly reduces perioperative anxiety and supports physiological stability. Their integration into routine nursing care for minor ophthalmic surgeries is both feasible and beneficial. Trial Registration: This study was registered with the Thai Clinical Trials Registry (TCTR) under registration number TCTR20250125002 on 25 January 2025. Full article

Background: Perioperative care is an integral part of the procedure of a surgical operation, with strictly defined rules. The need to upgrade and improve some individual long-term processes aims at optimal patient care and the provision of high-level health services. Therefore, preoperative care is drawn up with new data resulting from the evolution of technology to upgrade the procedures that need improvement. According to the international literature, a factor considered to be of major importance is high preoperative anxiety and its effects on the patient’s postoperative course. High preoperative anxiety is postoperatively responsible for prolonged hospital stays, increased postoperative pain, decreased effect of anesthetic agents, increased amounts of analgesics, delayed healing of surgical wounds, and increased risk of infections. The use of Virtual Reality technology appears as a new method of managing preoperative anxiety. Objective: This study investigates the effect and effectiveness of Virtual Reality (VR) technology in managing preoperative anxiety in adult patients. Methods: A literature review was performed on 193 articles, published between 2017 and 2024, sourced from the scientific databases PubMed and Cochrane, as well as the trial registry ClinicalTrials, with a screening and exclusion process to meet the criterion of investigating VR technology’s effectiveness in managing preoperative anxiety in adult patients. This systematic review was conducted under the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines. Results: Out of the 193 articles, 29 were selected. All articles examined the efficacy of VR in adult patients (≥18) undergoing various types of surgery. The studies represent a total of 2.354 participants from 15 countries. There are two types of VR applications: distraction therapy and patient education. From the studies, 14 (48%) used the distraction VR intervention, 14 (48%) used the training VR intervention, and 1 (4%) used both VR interventions, using a range of validated anxiety scales such as the STAI, VAS-A, APAIS, and HADS. Among the 29 studies reviewed, 25 (86%) demonstrated statistically significant reductions in preoperative anxiety levels following the implementation of VR interventions. VR technology appears to manage preoperative anxiety effectively. It is a non-invasive and non-pharmacological intervention with minimal side effects. Conclusions: Based on the review, the management of preoperative anxiety with VR technology shows good levels of effectiveness. Further investigation of the efficacy by more studies and randomized controlled trials, with a larger patient population, is recommended to establish and universally apply VR technology in the preoperative care process as an effective method of managing preoperative anxiety. Full article

Background: Multiple Chemical Sensitivity (MCS) is a complex, disabling condition marked by non-specific symptoms in response to low-level chemical exposures. It often leads to substantial impairments in quality of life, psychological health, and daily functioning. Although non-pharmacological approaches—such as lifestyle and psychological interventions—are widely used, their clinical effectiveness remains unclear. Objective: We aim to evaluate the effectiveness of lifestyle-based approaches in improving clinical and psychosocial outcomes in adults with Multiple Chemical Sensitivity. Methods: A systematic review was conducted in accordance with PRISMA guidelines (PROSPERO: CRD420251013537). Literature searches were carried out in MEDLINE (PubMed), CINAHL, Google Scholar, and ResearchGate between March and April 2025. Eligible studies included adults (≥18 years) with a confirmed diagnosis of MCS and reported outcomes such as perceived stress, anxiety, depressive symptoms, or quality of life. Methodological quality and risk of bias were independently assessed using the PEDro scale, NIH Quality Assessment Tool, CEBMa checklist, and Cochrane RoB 2.0. Results: Twelve studies (N = 378) met the inclusion criteria. Cognitive and behavioral therapies demonstrated the most consistent evidence of efficacy, with reductions in symptom severity, maladaptive cognitive patterns, and functional limitations. Mindfulness-based stress reduction showed favorable outcomes, while other mindfulness-based interventions yielded mixed results. Exposure-based therapies contributed to increased chemical tolerance and reduced avoidance behavior. Electromagnetic and biomedical approaches demonstrated preliminary but limited effectiveness. Aromatherapy was well tolerated and perceived as relaxing, though its clinical impact was modest. Conclusions: Cognitive and behavioral therapies appear to be most effective among lifestyle-based interventions for MCS/IEI. However, study heterogeneity limits the generalizability of findings, underscoring the need for more rigorous research. Full article

Background/Objectives: Dental anxiety in children is a common issue that can hinder the delivery of effective dental care. Traditional approaches to managing this are often insufficient or involve pharmacological interventions. This study shows the potential of virtual reality (VR) to aid in reducing anxiety in children undergoing simple dental procedures. By immersing children in relaxing VR environments (such as beaches, forests, mountains, or underwater scenes with calm music), the objective is to assess VR’s effectiveness in calming pediatrics patients during these procedures. Methods: Children scheduled for minor dental treatments wore a wearable device that monitored pulse, perspiration, and stress levels. Each child’s baseline data was collected without the VR headset, followed by data collection during VR exposure before and during dental procedures. VR scenarios ranged from soothing nature scenes to animated cartoons, designed to foster relaxation. Results: The data collected showed a reduction in physiological indicators of stress, such as lower heart rate and reduced perspiration, when the VR headset was used. Children appeared more relaxed, with a calmer response during the procedure itself, compared to baseline levels without VR. Conclusions: This study provides preliminary evidence supporting VR as an effective tool for reducing anxiety and stress in pediatric dental patients. By offering an engaging, immersive experience, VR can serve as an alternative or complementary approach to traditional anxiety management strategies in pediatric dentistry, potentially improving patient comfort and cooperation during dental procedures. Further research could determine if VR may serve as an alternative to local anesthesia for non-intrusive pediatric dental procedures. Full article

Background: Emerging evidence highlights the role of physical exercise as a non-pharmacological intervention for reducing symptoms of anxiety and depression. While most research has focused on aerobic modalities and chronic training programs, the acute psychological impact of resistance training (RT)—particularly in healthy, active individuals—remains underexplored. This study addresses this gap by evaluating the immediate effects of a single RT session on anxiety and depression in healthy, active individuals. Methods: Fifty-six healthy, physically active participants (43 males, 13 females; M age = 24.41 ± 4.41 years) were randomly assigned to an experimental group (RT, n = 30) or a control group (stretching/mobility, n = 26). The RT session included multi-joint exercises performed at 70–75% 1RM, while the control session consisted of non-load-based mobility and flexibility exercises. Psychological responses were measured immediately before and five minutes after the session using the Hospital Anxiety and Depression Scale (HADS), which includes subscales for anxiety (HADS-A) and depression (HADS-D). Results: Non-parametric within-group analysis (Wilcoxon Signed-Rank Test) revealed a significant reduction in anxiety scores in the RT group (Z = −3.3, p < 0.001, r = −0.7), and a moderate but significant decrease in depression (Z = −2.8, p = 0.005, r = −0.6). No significant changes were observed in the control group for either variable. Between-group comparisons (Mann–Whitney U) showed significantly greater reductions in anxiety in the RT group (p = 0.021), while differences in depression deltas were not significant. A Quade ANCOVA confirmed that group assignment is significantly predictive for post-intervention anxiety levels (F(1, 54) = 8.46, p = 0.005), controlling for baseline values. Conclusions: A single session of moderate-to-high-intensity resistance training can acutely reduce anxiety symptoms in healthy physically active individuals. The effect on depressive symptoms appears more modest and variable, suggesting differential sensitivity to acute exercise stimuli. These findings support the use of RT not only for long-term psychological health but also as a feasible short-term intervention for emotional regulation in healthy active populations. Full article

Migraine is a common disabling primary headache disorder with significant personal and socio-economic impacts. A combination of medication and non-pharmacological therapies is essential for migraine management. Outpatient multidisciplinary headache therapy has not yet been evaluated in Switzerland. This study evaluates the effectiveness of the headache management program at Inselspital, Bern University Hospital, in improving headache-related disability in migraine patients. This open-label pilot study used prospectively assessed routine data from our headache registry. Participants aged 18 years or older with a diagnosis of migraine, confirmed by a headache specialist, were included. The program consisted of seven weekly sessions, each with a 50 min educational lecture and a 30 min progressive muscle relaxation (PMR) exercise. Primary outcomes were headache-related impact and disability, measured by the Headache Impact Test 6 (HIT-6) and Migraine Disability Assessment (MIDAS). Secondary outcomes included symptoms of anxiety, measured by the Generalized Anxiety Disorder 7-item scale (GAD-7), and symptoms of depression, assessed using the eight-item Patient Health Questionnaire depression scale (PHQ-8). Data were analysed using paired t-test and Wilcoxon signed rank tests. Significant improvements were observed in HIT-6 scores (pre-program: 65.2; post-program: 61.9; p = 0.012) and MIDAS scores (pre-program: 38; post-program: 27; p = 0.011), while PHQ-8 also showed a statistically significant reduction. Although the GAD-7 scores improved numerically, this change was not statistically significant. These findings suggest that the headache management program may reduce headache burden and disability; however, further research with larger samples is needed to confirm these preliminary results. Full article

Background and Objectives: Psychological distress is a pervasive yet often undertreated aspect of the cancer experience, contributing to reduced quality of life, poorer treatment adherence, and worse health outcomes. This systematic review and meta-analysis evaluated the efficacy of non-pharmacological, evidence-based psychological interventions on distress, depression, anxiety, coping capacity, and quality of life in adult cancer patients. Interventions were grouped into three domains: structured psychotherapeutic therapies (e.g., Cognitive Behavioral Therapy [CBT], Acceptance and Commitment Therapy [ACT], Meaning-Centered Psychotherapy [MCP]); mindfulness and stress reduction programs (e.g., Mindfulness-Based Stress Reduction [MBSR], Mindfulness-Based Cognitive Therapy [MBCT]); and coping and resilience-enhancing modalities (e.g., Promoting Resilience in Stress Management [PRISM], expressive writing). Materials and Methods: Following PRISMA guidelines, 42 randomized controlled trials published between 2015 and 2025 were included. A stratified meta-analytic approach calculated pooled standardized mean differences for each intervention class and outcome. Heterogeneity, subgroup, and moderator analyses explored drivers of effect variability. Results: Structured psychotherapeutic interventions yielded the largest effects, especially for depression. Mindfulness-based interventions produced moderate but significant improvements in distress and emotional regulation. Coping and resilience programs provided smaller yet statistically significant gains in adaptive coping. Between-study heterogeneity was moderate, partly explained by intervention type, delivery modality, and cancer subtype. Conclusions: These findings support integrating psychosocial care into standard oncology protocols and endorse its routine implementation as a core component of comprehensive cancer treatment. Full article

Background and Objectives: Chronic respiratory diseases, such as COPD, cystic fibrosis, and post-COVID-19, are frequently accompanied by psychological distress and physical impairment. As a non-pharmacological intervention, progressive muscle relaxation (PMR) may benefit these patients psychologically and physiologically. This systematic review aimed to evaluate the effects of PMR on anxiety, depression, fatigue, sleep quality, dyspnea, and pulmonary function in patients with COPD, CF, and COVID-19. Materials and Methods: Following PRISMA guidelines, a comprehensive search was conducted across PubMed, Scopus, Web of Science, MEDLINE, Cochrane, SpringerLink, and ClinicalTrials.gov. Eligible studies assessed PMR in adult patients with COPD, CF, or COVID-19. Psychological and physical outcomes were extracted, and methodological quality and risk of bias were evaluated using standardized tools. Results: A total of 32 studies were included in the analysis. PMR was consistently associated with reductions in anxiety, depression, fatigue, and sleep-related distress, particularly in patients with COPD and COVID-19. Some also reported improvements in dyspnea and mild pulmonary function tests, but these were more variable. Only one study evaluated PMR in patients with cystic fibrosis, providing the first clinical data for this group. Interventions were predominantly short-term, with significant variation in design, duration, and methodology, and the risk of bias was often moderate or high. Conclusions: PMR is a helpful strategy in treating chronic respiratory diseases, particularly for reducing psychological distress and improving sleep. However, the evidence is limited by methodological variations and lack of long-term follow-up. Rigorous research is needed to support clinical application, particularly in cystic fibrosis. Full article

Background and Objectives: Dental anxiety is a common barrier to pediatric oral care. Non-pharmacological relaxation techniques like Jacobson’s Progressive Muscle Relaxation (JPMR) and Breathing Control (BC) may help reduce psychological and physiological stress. This study assessed the utility of JPMR and BC in reducing dental anxiety and physiological arousal in children and adolescents. Materials and Methods: In this observational study, 189 participants aged 8–17 undergoing non-invasive dental procedures were assigned to JPMR (n = 63), BC (n = 63), or control (n = 63) groups. Dental anxiety was measured with the Romanian-validated IDAF-4C⁺, and physiological stress was measured via blood pressure and heart rate. Pre and post-intervention data were analyzed using paired t-tests, ANOVA, and cluster analysis. Results: JPMR led to the highest reductions in IDAF-4C⁺ scores (Δ = −1.23, p < 0.001, d = 1.12) and systolic blood pressure (Δ = −9.4 mmHg, p < 0.01). BC showed moderate anxiety reduction (Δ = −0.64, p < 0.05, d = 0.61) with minor physiological changes. The control group showed no significant change. Cluster analysis revealed three response patterns: (1) high anxiety–strong responders (n = 58), mainly benefiting from JPMR; (2) moderate anxiety–partial responders (n = 74); and (3) low anxiety–non-responders (n = 57). Younger age and female gender were linked to better JPMR response. Conclusions: JPMR is an effective and practical method for reducing dental anxiety and physiological stress in pediatric dental care. Full article

(1) Background: Immersive virtual reality (IVR) has emerged as a promising non-pharmacological intervention to promote relaxation and improve emotional well-being in this population. (2) Methods: This crossover study evaluated the effects of IVR on anxiety and psychological well-being in a sample of eight participants with mild dementia attending a day-care center. Participants underwent two conditions: an experimental condition involving relaxing nature-based VR scenarios (Nature Treks VR) and a control condition using personalized YouTube videos on a tablet. Each condition lasted 12 sessions. Assessments included heart rate (HR), the I-PANAS-SF, the reduced State–Trait Anxiety Inventory (STAI-r), behavioral observations, and a subjective response questionnaire. (3) Results: A significant reduction in HR over time was found during IVR exposure, suggesting a calming physiological effect not observed in the control condition. While changes in PANAS and STAI-r scores were not statistically significant, the PANAS score improvement in the experimental condition approached statistical significance (p = 0.054) and was just below the minimal clinically important difference (MCID), suggesting a potentially meaningful trend. Behavioral responses were higher during YouTube sessions, likely due to personalized content. All participants rated the IVR experience positively on the subjective questionnaire, indicating high acceptability, though social desirability bias cannot be excluded. (4) Conclusions: IVR appears to be a feasible and acceptable intervention for individuals with dementia, warranting further investigation. Full article

Preoperative anxiety affects approximately 80% of adult patients; thus, identifying patients with excessive anxiety and implementing appropriate interventions can significantly reduce the risk of deterioration during the perioperative period. This narrative review presents current knowledge about pharmacological and nonpharmacological methods for reducing preoperative anxiety. Commonly used pharmacological options include benzodiazepines, ketamine, or fentanyl. Antidepressants have also been shown to be effective in alleviating symptoms, but they typically require four weeks to take effect. Establishment of supportive relationships with medical staff to help patients express their feelings have been shown to have a positive impact on anxiety reduction. Other nonpharmacological methods include the provision of information through informed consent forms, video materials, virtual reality, or the use of psychotherapeutic interventions such as breathing techniques, music therapy, or cognitive–behavioural therapy. Some studies suggest that essential oils may have a role in reducing perioperative anxiety. Nonpharmacological interventions can be used in patients of different ages. An increasing number of researchers advocate for a holistic approach that integrates less invasive and cost-effective interventions with conventional medicine. While various interventions have been proposed to manage preoperative anxiety, more research is needed to establish the most effective and feasible interventions for different patient populations. Full article

Background/Objective: Cystic fibrosis (CF) is a chronic genetic disease affecting multiple body systems and having a significant impact on mental health and sleep. Patients with CF frequently suffer from anxiety, depression, and sleep disturbances, but non-pharmacological strategies are understudied. Although progressive muscle relaxation (PMR) has recognized benefits, its impact on CF remains insufficiently explored. The study aimed to analyze the effect of integrating PMR into a standard pulmonary rehabilitation (PR) program on mental health, sleep quality, and quality of life in adults with CF. Methods: A total of 22 adult patients with CF were randomly assigned to either the intervention group (PR + PMR) or the control group (PR only). Assessments were performed at baseline, after 21 days of intervention, and at the 48-day follow-up. Outcome measures included the CFQ-R for quality of life, the HADS for mental health, and the PSQI for sleep. Results: Compared to the control group, participants who practiced PMR experienced significant reductions in anxiety (p = 0.05) and depression (p = 0.02) at the final assessment. A significant improvement in sleep quality was also observed (p < 0.01). No relevant differences were found in pulmonary function or performance on the six-minute walk test. Conclusions: Integrating PMR into pulmonary rehabilitation programs may be an effective strategy for improving mental health and sleep in patients with CF. Due to its accessibility and ease of implementation, PMR could be adopted as a complementary method in the holistic care of these patients. Full article

Background and Objectives: Mental health disorders, including major depressive disorder and adjustment disorder with mixed anxiety and depressed mood, present a significant global burden, with early onset and progression leading to substantial individual and social impacts. While pharmacotherapy remains the standard treatment, many patients experience inadequate symptom relief or intolerable side effects. In this context, transcranial magnetic stimulation (TMS) has emerged as a non-invasive, well-tolerated neuromodulation technique offering an alternative treatment option. Although its clinical efficacy is well-documented, limited research exists on patient perceptions, decision-making processes and barriers to TMS utilization in private healthcare settings, particularly in Romania. This study explores patients’ experiences with TMS, factors influencing their treatment choices and comparative views on its acceptability relative to pharmacological interventions. Materials and Methods: A qualitative research design was employed, using semi-structured interviews with 20 patients diagnosed with MDD or AD who had undergone TMS therapy as part of two pilot studies which were non-randomized in Romanian private practices. Data were collected via interviews and analyzed thematically to identify patterns in patient perceptions, decision-making factors and treatment experiences. Results: Participants reported predominantly positive perceptions of TMS, citing improvements in mood, anxiety reduction, and enhanced daily functioning. The most common motivations for seeking TMS included dissatisfaction with pharmacotherapy, recommendations from physicians or peers and information obtained via online sources. TMS was perceived as a safer and more tolerable alternative to medication, particularly due to its lack of systemic side effects. However, barriers such as high treatment costs, limited insurance coverage and logistical challenges in accessing TMS services were noted as significant deterrents. Conclusions: The study highlights the strong preference for TMS among patients who seek alternatives to pharmacotherapy, with key motivators including efficacy, tolerability and non-invasiveness. However, systemic barriers to access remain a critical challenge in private healthcare settings. Future research should focus on expanding accessibility, improving patient education and integrating TMS into broader mental healthcare frameworks to optimize treatment outcomes. Full article

Symptoms of depression represent a significant burden to patients with breast cancer, not only because of the psychological stress associated with their diagnosis, but also because of the adverse effects of its treatment. We reviewed the clinical trials examining the management of the symptoms of depression in breast cancer patients through different non-pharmacological interventions in different databases (PubMed, Embase, Scopus, and the American Psychological Association). Cognitive behavioural therapy, interpersonal psychotherapy or psychodynamic psychotherapy, as well as acceptance and commitment therapy have been effective in improving symptoms of depression in cancer patients with moderate to severe symptoms. Physical exercise, yoga, mindfulness, and support groups have been shown to benefit patients with mild depressive symptoms. These interventions not only showed positive results in interventions in women with breast cancer in terms of the symptoms of depression, but also highlighted their benefits for comorbid anxiety, stress, and poor sleep quality; moreover, it is suggested that these interventions should be leveraged to manage mental health issues in breast cancer patients. The molecular effects of these interventions, such as the reduction in inflammatory cytokines and cortisol levels, have seldom been reported and need further studies. Full article

Background and aims: Aframomum melegueta (A. melegueta) from the ginger family is appreciated for its pungent seeds widely used in African ethno-medicine. Among the several biological activities associated with the seed’s preparations, some preclinical studies suggest a set of neuroactive properties that have not been tested in humans to date. We performed a clinical trial to investigate the effects of A. melegueta seed extracts on anxiety, stress, mood, and sleep in healthy subjects with moderate anxiety levels. In vitro pharmacological assays targeting the endocannabinoid, serotoninergic, and GABAergic systems were conducted to elucidate the underlying mechanism of action. Methods: A. melegueta standardized to 10% total vanilloids (primarily 6-gingerol, 6-shogaol, and 6-paradol) was obtained after hydroalcoholic extraction and the spray-drying microencapsulation process. Subjects consumed 50, 100, or 150 mg of the extract daily for three days. A set of validated psychometric test questionnaires was collected before and 48 h after the first intake. A. melegueta extract interaction with canonical endocannabinoid receptors (hCB1R and hCB2R), the serotonin receptor (5HT1AR) and gamma-aminobutyric acid receptor (GABAA1R) was evaluated by the radioligand binding assay. Additionally, receptor functional assays and enzyme inhibition assays were conducted to test the extract’s functional activity on the non-canonical endocannabinoid receptor (TRPV1) and the cannabinoid fatty-acid amide hydrolase enzyme (FAAH), respectively. Results: In vitro pharmacological tests showed that the A. melegueta extract activated TRPV1, modulated both hCB2R and 5HT1AR and inhibited FAAH, which is the enzyme primarily responsible for hydrolyzing endogenous anandamide. After a 48 h intake period, the extract significantly reduced anxiety and tension related to stress, improved overall mood, and enhanced sleep quality in the participants at doses ranging from 50 to 150 mg, with no reported side effects. Conclusions: This study supports the potential of the A. melegueta extract for anxiety reduction, mood improvement, stress mitigation, and sleep enhancement. The in vitro tests suggest that the extract’s primary mechanism of action may involve the inhibition of FAAH, which is a key target in anxiety management. Full article