Emotion and Adaptation

Interest in meaning and meaning making in the context of stressful life events continues to grow, but research is hampered by conceptual and methodological limitations. Drawing on current theories, the author first presents an integrated model of meaning making. This model distinguishes between the constructs of global and situational meaning and between "meaning-making efforts" and "meaning made," and it elaborates subconstructs within these constructs. Using this model, the author reviews the empirical research regarding meaning in the context of adjustment to stressful events, outlining what has been established to date and evaluating the strengths and weaknesses of current empirical work. Results suggest that theory on meaning and meaning making has developed apace, but empirical research has failed to keep up with these developments, creating a significant gap between the rich but abstract theories and empirical tests of them. Given current empirical findings, some aspects of the meaning-making model appear to be well supported but others are not, and the quality of meaning-making efforts and meanings made may be at least as important as their quantity. This article concludes with specific suggestions for future research.

Making Sense of the Meaning Literature: An Integrative Review of Meaning Making and Its Effects on Adjustment to Stressful Life Events.

Objective:To update and expand the 2013 Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the ICU.Design:Thirty-two international experts, four methodologists, and four critical illness survivors met virtually at least monthly. All section groups g

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Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU

Objective: Meta-analyses of behavior change (BC) interventions typically find large heterogeneity in effectiveness and small effects. This study aimed to assess the effectiveness of active BC interventions designed to promote physical activity and healthy eating and investigate whether theoretically specified BC techniques improve outcome. Design: Interventions, evaluated in experimental or quasi-experimental studies, using behavioral and/or cognitive techniques to increase physical activity and healthy eating in adults, were systematically reviewed. Intervention content was reliably classified into 26 BC techniques and the effects of individual techniques, and of a theoretically derived combination of self-regulation techniques, were assessed using meta-regression. Main Outcome Measures: Valid outcomes of physical activity and healthy eating. Results: The 122 evaluations (N 44,747) produced an overall pooled effect size of 0.31 (95% confidence interval 0.26 to 0.36, I 2 69%). The technique, “self-monitoring,” explained the greatest amount of among-study heterogeneity (13%). Interventions that combined selfmonitoring with at least one other technique derived from control theory were significantly more effective than the other interventions (0.42 vs. 0.26). Conclusion: Classifying interventions according to component techniques and theoretically derived technique combinations and conducting meta-regression enabled identification of effective components of interventions designed to increase physical activity and healthy eating.

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Effective Techniques in Healthy Eating and Physical Activity Interventions: A Meta-Regression

State-Trait Anxiety Inventoryによるペインクリニック外来患者の不安の評価

Open-heart surgery patients report anxiety and pain with chair rest despite opioid analgesic use. The effectiveness of non-pharmacological complementary methods (sedative music and scheduled rest) in reducing anxiety and pain during chair rest was tested using a three-group pretest-posttest experimental design with 61 adult postoperative open-heart surgery patients. Patients were randomly assigned to receive 30 min of sedative music (N=19), scheduled rest (N=21), or treatment as usual (N=21) during chair rest. Anxiety, pain sensation, and pain distress were measured with visual analogue scales at chair rest initiation and 30 min later. Repeated measures MANOVA indicated significant group differences in anxiety, pain sensation, and pain distress from pretest to posttest, P<0.001. Univariate repeated measures ANOVA (P< or =0.001) and post hoc dependent t-tests indicated that in the sedative music and scheduled rest groups, anxiety, pain sensation, and pain distress all decreased significantly, P<0.001-0.015; while in the treatment as usual group, no significant differences occurred. Further, independent t-tests indicated significantly less posttest anxiety, pain sensation, and pain distress in the sedative music group than in the scheduled rest or treatment as usual groups (P<0.001-0.006). Thus, in this randomized control trial, sedative music was more effective than scheduled rest and treatment as usual in decreasing anxiety and pain in open-heart surgery patients during first time chair rest. Patients should be encouraged to use sedative music as an adjuvant to medication during chair rest.

https://www.cirmmt.org/activities/workshops/research/music-pain/images/music-after-cardiac-surgery-pain-2004

Sedative music reduces anxiety and pain during chair rest after open-heart surgery

A pilot study tested the relationship between human milk oligosaccharide consumption, oligosaccharide content of feces, and subsequent disease in breastfed infants. Forty-nine (49) mother–infant pairs provided milk and fecal samples 2 weeks postpartum; infant health was assessed through 2, 6, 12, and 24 weeks. LNF-II (lacto-N-fucopentaose II), a major human milk oligosaccharide, was measured to represent levels of total oligosaccharides consumed in milk and remaining in feces. LNF-II levels in milk at 2 weeks postpartum were associated with fewer infant respiratory problems by 6 weeks (p = 0.010), as were LNF-II levels in infant feces (p = 0.003). LNF-II levels in milk at 2 weeks were also associated with fewer respiratory problems by 12 weeks (p = 0.038), and fewer enteric problems by 6 weeks (p = 0.004) and 12 weeks (p = 0.045). Thus, consumption of human milk oligosaccharides through breastfeeding, represented by LNF-II, was associated with less reported respiratory and gastrointestinal illness in infants.

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Early Consumption of Human Milk Oligosaccharides Is Inversely Related to Subsequent Risk of Respiratory and Enteric Disease in Infants

This research examined the relationship of cognitive-perceptual determinants from the Health Promotion Model to physical activity and healthy eating at baseline of a clinical trial among rural women aged 50 to 69. Two multivariate regression analyses with canonical correlation (N = 179) each yielded one interpretable canonical variate that explained similar amounts of variance (21.7% and 22.5%) in sets of activity and eating variables. In both analyses, the determinants set is a linear combination of all four cognitive-perceptual constructs from the model (perceived self-efficacy, benefits, barriers, interpersonal influences). The activity behavior set included caloric expenditure, VO2max, and stretching and strengthening activity, whereas the eating behavior set included daily percentage of calories from fat and servings of fruits and vegetables, meat, and whole grains. As predicted by theory, greater self-efficacy, benefits and interpersonal support, and fewer barriers are associated with desirable heal...

Determinants of older rural women's activity and eating.

Objective To explore the feasibility of using motivational interviewing to promote sustained breastfeeding by increasing a mothers intent to breastfeed for 6 months and increasing her breastfeeding self-efficacy. Design A longitudinal experimental two-group design with repeated measures was selected to explore the feasibility of using motivational interviewing to promote sustained breastfeeding in primiparous mothers. Setting Three Western rural community hospital sites. Participants Convenience sample of 73 primiparous breastfeeding mothers ranging between the ages of 19 and 38, M = 25 ( SD = 4.5). Main outcome measure Mothers reported the date of their last day of breastfeeding, defined as any breastfeeding during the previous 24-hour period. Breastfeeding behavior was confirmed at each visit by infant test weights. Results The motivational interviewing group ( M = 98.1 days, SD = 75.2) breastfed longer than the comparison group ( M = 80.7 days, SD = 71.9); however, this difference was not significant, t (69) = 0.991, p = .325, Cohens d = 0.24, related to the variability in the sample. Conclusions Although not a statistically significant difference, the mean number of days that mothers in the intervention group breastfed was 98 days compared to the mean of 81 days by the comparison group; therefore, motivational interviewing may be useful as a strategy to test in a comprehensive intervention plan. JOGNN, 35, 340-348; 2006. DOI: 10.1111/J.1552-6909.2006.00046.x

Motivational Interviewing to Promote Sustained Breastfeeding

Physical activity is associated with health and reduced mortality risk, yet only15% ofU.S. adults achieve adequate activity. This study is an experimental repeated measures nested design randomizing two similar rural communities to investigate the effectiveness of the Heart and Soul Physical Activity Program (HSPAP) (Peterson, 2002) in promoting physical activity in midlife women (n =42) aged 35 to 65 years. The HSPAP, an innovative church-based health promotion intervention, is conceptualized in social support and designed to increase physical activity, energy expenditure (EE), and cardiorespiratory fitness (VO2 max), measured over time. A significant interaction (p < .001) was found for EE in one HSPAP group increasing their EE by 1,010 kcals/week. HSPAP participants increased their VO2 max level by 75% (p < .001) and 10%; comparison groups stayed the same or declined 16%. Study results provide preliminary support for the HSPAP intervention as an effective treatment to improve physical activity levels i...

Melody Hertzog

Papers

Sedative music reduces anxiety and pain during chair rest after open-heart surgery

Early Consumption of Human Milk Oligosaccharides Is Inversely Related to Subsequent Risk of Respiratory and Enteric Disease in Infants

Determinants of older rural women's activity and eating.

Motivational Interviewing to Promote Sustained Breastfeeding

Effects of a physical activity intervention for women.