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NIHR Signal Virtual reality can help reduce the pain and anxiety of stressful medical procedures for children
Virtual reality shows promise in helping to distract children from self-reported pain and anxiety during medical procedures. Younger children in particular may benefit from the intervention. This review of seventeen trials looked at virtual reality interventions tested in trials with children receiving treatment for burns, dental and tumour related health needs, and during needle insertion for intravenous access. Results suggested a marked impact on pain and anxiety of children from these immer...
NIHR Signal Pulmonary rehabilitation may modestly improve anxiety and depression in adults with chronic obstructive pulmonary disease
Pulmonary rehabilitation for chronic obstructive pulmonary disease (COPD) improves psychological symptoms modestly, compared with no intervention. Depression improves by about 2.5 points, and anxiety by 2.2 points on the Hospital Anxiety and Depression Scale (range 0 to 21). This review of 10 trials is the first to show that pulmonary rehabilitation – already known to improve quality of life and exercise capacity - may also improve anxiety and depression, which are common in people with C...
NIHR Signal Meaningful increases in physical activity levels after cancer can be sustained for three months or more
People who have had cancer, who are able to keep mobile, can benefit from interventions aimed at increasing physical activity. Being active regularly is already known to improve health and may also reduce the risk of cancer returning and improve life expectancy. This NIHR-funded review looked at what kinds of exercise interventions can lead to behaviour change in adult cancer survivors. Researchers specifically looked at the components that are linked to continued physical activity at least thr...
NIHR Signal Telephone or internet delivered talking therapy can alleviate irritable bowel symptoms
People with irritable bowel syndrome may find cognitive behavioural therapy (a talking therapy) delivered via telephone or internet improves their symptoms. Compared with usual care alone, both interventions were shown to be more effective, with telephone delivery resulting in greater symptom reduction and web-based therapy being more cost-effective. Irritable bowel symptoms can persist long-term and have a major impact on the quality of life. Stress is one of the known triggers. Cognitive beha...
NIHR Signal Psychological therapies may improve parenting skills in parents of children with chronic illness
Psychological therapies appear to show promise in helping improve self-reported parenting behaviour of parents of children and adolescents with cancer, chronic pain, diabetes or traumatic brain injury. Cognitive behavioural therapy (CBT) and problem-solving therapy (PST) appear particularly valuable in supporting this. Psychological therapies also seemed beneficial in improving the mental health of parents who have children with cancer and chronic pain, but not in studies of children with diabe...
NIHR Signal Steps to better understanding resistant behaviours and the culture of bedside dementia care in hospitals
High levels of resistance to care by people with dementia can be exacerbated by responses by staff on the wards. This study sought to understand the interactions and culture underlying care by closely observing and documenting what was actually happening on ten wards in five UK hospitals, and through interviews with carers and families. This in-depth study confirmed that people living with dementia are often resistant to care in acute hospital settings. Behaviour included wandering in wards, pu...
NIHR Signal Goal-setting can help people with early-stage dementia improve function
Goal-setting as part of cognitive rehabilitation delivered by occupational therapists helped people with early dementia progress towards independence in daily tasks, with benefits lasting for nine months. This approach focuses on the everyday tasks needing concentration and memory and prioritising those that matter most to individuals, from using the cooker or answering the phone. The intervention was well-received, but the cost-effectiveness is not clear, because quality of life continued to de...
NIHR Signal New insights into how ethnicity and culture affect maternal mental health
Ethnicity and culture can affect how and when women seek help for mental health problems before or after having a baby. Many women avoid seeking help because they feel services are not sensitive to their beliefs. Services should ensure all women, regardless of background, can access the support they need during and after pregnancy. This mixed methods systematic review of UK evidence found that many women are not aware of the help available to them, and those that are aware often view it negativ...
NIHR Signal E-cigarettes helped more smokers quit than nicotine replacement therapy
Smokers who use NHS stop smoking services appear almost twice as likely to be successful for a year if they use e-cigarettes than if they use nicotine replacement therapy (NRT) products. In a trial of 866 smokers who used NHS stop smoking services, 18% of those assigned to e-cigarettes were abstinent 12 months from their quit date, compared to 9.9% of those assigned to NRT. Everyone in the study was also offered four weeks of one-to-one behavioural support from a clinician. Of those who had suc...
NIHR Signal Various drugs are effective and well-tolerated for generalised anxiety disorder
There are various drugs options for the treatment of generalised anxiety disorder, from different medication classes. This study found that most evidence was available for the serotonin and noradrenaline re-uptake inhibitors (SNRI) duloxetine and venlafaxine, the selective serotonin reuptake inhibitor (SSRI) escitalopram, and the anti-epileptic pregabalin. All appear well-tolerated and reduce symptoms compared with placebo. The SSRI sertraline, commonly used in practice, was equally effective an...
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