ABSTRACT
O artigo apresenta análise das contribuições e os desafios das práticas corporais e meditativas à promoção da saúde na rede pública de atenção primária. A pesquisa qualitativa foi desenvolvida em 16 unidades de saúde do Município de São Paulo, Brasil, por meio de entrevistas de 29 profissionais e 36 praticantes, e observação participante de 31 práticas, entre Tai Chi, Lian Gong, Qi Gong, Yoga, Capoeira, Danças, Meditação, Relaxamento, Consciência e Percepção Corporal. Houve melhora de dores articulares, mobilidade, equilíbrio, memória, depressão e ansiedade, e maior facilidade ao lidar com condições crônicas. Tais contribuições são relacionadas ao favorecimento da autonomia dos praticantes, pela construção de referências de saúde por intermédio do autoconhecimento; à união entre promoção e cuidado terapêutico nas abordagens; e ao apoio ao acesso a bens culturais e espaços de cidadania. Os desafios identificados são a precariedade na integração com as demais ofertas dos serviços de saúde, a carência de supervisão e avaliação, assim como o predomínio de uma cultura setorial na saúde.
The article presents an analysis of contributions and challenges associated with bodily practices and meditation for health promotion in the public primary care system. The qualitative study was developed in 16 healthcare units in the city of São Paulo, Brazil, using interviews with 29 health professionals and 36 practitioners of bodily practices and meditation, including participant observation of 31 practices such as Tai Chi, Lian Gong, Qigong, Yoga, Capoeira, Dance, Meditation, Relaxation, Mindfulness, and Body Awareness. There was an improvement in joint pain, mobility, balance, memory, depression, and anxiety, besides greater ease in coping with chronic conditions. Such contributions are related to favoring practitioners' autonomy, building health references through self-awareness; the combination of health promotion and therapeutic care in the approaches; and support for access to cultural goods and community spaces. The challenges identified here were precarious integration with the supply of other health services, lack of supervision and evaluation, and the predominance of a health-sector culture.
El artículo presenta un análisis de las contribuciones y los desafíos de las prácticas corporales y meditativas a la promoción de la salud en la red pública de atención primaria. La investigación cualitativa se desarrolló en 16 unidades de salud del municipio de São Paulo, Brasil, mediante entrevistas de 29 profesionales y 36 practicantes, y una observación participante de 31 prácticas, entre Tai Chi, Lian Gong, Qi Gong, Yoga, Capoeira, Bailes, Meditación, Relajamiento, Consciencia y Percepción Corporal. Hubo una mejora de los dolores articulares, movilidad, equilibrio, memoria, depresión y ansiedad, y mayor facilidad al lidiar con condiciones crónicas. Tales contribuciones se relacionan con el favorecimiento de la autonomía de los practicantes, por la construcción de referencias de salud mediante el autoconocimiento; a la unión entre promoción y cuidado terapéutico en los enfoques; y el apoyo al acceso a bienes culturales y espacios de ciudadanía. Los desafíos identificados son la precariedad en la integración con las demás ofertas de los servicios de salud, la carencia de supervisión y evaluación, así como el predominio de una cultura sectorial en la salud.
Subject(s)
Humans , Male , Female , Primary Health Care/methods , Public Health Practice , Meditation/methods , Mind-Body Therapies/methods , Health Promotion/methods , Social Environment , Brazil , Interviews as Topic , Reproducibility of Results , Treatment Outcome , Qualitative ResearchABSTRACT
PURPOSE: The study aimed to develop a mind-body therapeutic program and evaluate its effects on mitigating uncertainty, anxiety, and implantation rate of second-trial in vitro fertilization (IVF) women. METHODS: This study employed a nonequivalent control group nonsynchronized design. The conceptual framework and program content were developed from a preliminary survey of eight infertile women and the extensive review of the literature. Program focuses on three uncertainty-induced anxieties in infertile women: cognitive, emotional, and biological responses. To evaluate the effect of the intervention, the infertile women with unknown cause preparing for a second IVF treatment were sampled at convenience (26 experimental and 24 control). RESULTS: The experimental group in the study showed greater decrease in uncertainty and anxiety in premeasurements and postmeasurements than the control group did. However, no statistically significant differences in the implantation rate between groups were observed. CONCLUSION: This study is meaningful as the first intervention program for alleviating uncertainty and anxiety provided during the IVF treatment process. The positive effects of the mind-body therapeutic program in alleviating both uncertainty and anxiety have direct meaning for clinical applications.
Subject(s)
Adult , Female , Humans , Anxiety/psychology , Case-Control Studies , Embryo Implantation , Fertilization in Vitro/psychology , Infertility, Female/psychology , Mind-Body Therapies/methods , Treatment Outcome , Uncertainty , Women/psychologyABSTRACT
OBJECTIVE: As insomnia is highly prevalent, and side effects of medication are well-known, mind-body interventions are increasingly being sought. The objective of this study is to present a narrative review regarding the effects of mind-body interventions for the treatment of insomnia. METHOD: A PubMed search was conducted including only randomized, controlled trials in which the main objective was to treat insomnia. DISCUSSION: Twelve studies were selected. In three of the studies, objective parameters (polysomnography) were analyzed. Mind-body interventions were able to improve sleep efficiency and total sleep time. Most can ameliorate sleep quality; some can reduce the use of hypnotic drugs in those who are dependent on these drugs. CONCLUSION: According to the studies we selected, self-reported sleep was improved by all mind-body treatments, among them yoga, relaxation, Tai Chi Chih and music. Cognitive behavioral therapy seems to be the most effective mind-body intervention. Cognitive behavioral therapy was the only intervention that showed better results than medication. However, considering that only five of the twelve studies chosen reached a score of 3 in the Jadad scale, new studies with a higher methodological quality have to be conducted especially in mind-body interventions that belong to the complementary or alternative medicine field.
OBJETIVO: Considerando-se que a insônia é altamente prevalente, e os efeitos colaterais das medicações para seu tratamento são bem conhecidos, pesquisas no campo das intervenções mente-corpo têm sido desenvolvidas. O objetivo deste estudo é apresentar uma revisão narrativa sobre os efeitos das intervenções mente-corpo para o tratamento de insônia. MÉTODO: Uma busca pelo site Pubmed foi conduzida incluindo-se apenas estudos controlados e randomizados nos quais o principal objetivo era o tratamento da insônia. DISCUSSÃO: Doze estudos foram selecionados. Em três deles, parâmetros objetivos (polissonografia) foram analisados. Vários destes estudos mostraram melhora na qualidade do sono; em grupos de usuários de drogas hipnóticas ocorreu redução no uso das mesmas. CONCLUSÃO: De acordo com os estudos selecionados, todas as intervenções mente-corpo melhoraram ao menos a qualidade subjetiva do sono, dentre elas yoga, Tai Chi Chih e música. A terapia comportamental cognitiva parece ser a mais efetiva destas intervenções e foi a única que mostrou melhores resultados que a medicação. Porém, considerando que apenas cinco dos 12 estudos selecionados alcançaram o escore 3 na escala de Jadad, novos estudos com melhor qualidade metodológica precisam ser conduzidos especialmente dentre as intervenções mente-corpo que estão no campo das práticas complementares ou alternativas.