CANCER & MEDITATION.
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Completed study to measure impact of meditation on perceived pain intensity of cancer patients. Tables.... More...
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Completed study to measure impact of meditation on perceived pain intensity of cancer patients. Tables.
ABSTRACT PURPOSE The purpose of this study was to investigate the impact of meditation on the perceived pain intensity of cancer patients. It was felt that such a study would assist in providing physicians and other medical care providers with a more empirical look at alternative treatments for cancer pain and that, as a result, they and other medical care personnel would be more inclined to use these alterative treatments for pain patients in general and cancer pain patients in particular. HYPOTHESIS The conducted study tested the hypothesis that the level of pain intensity subjects were perceiving at present (as measured by PPI scores on the short form of the McGill Pain Questionnaire)
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McCarberg, B. MethodsSample All of the subjects (N=15) in the study were drawn from the OncologyWard at Montefiore Hospital. Future researchers may wish to examine whether the effects ofmeditation, if any, are significantly associated with differences insubjects' ages and/or ethnic background. Psychological researchmethods: A conceptual approach. All subjects volunteered to be in the study after having itexplained to them and signing an informed consent form. Mindfulness meditation uses one'sbreathing as the focus of attention (Roth & Creaser, 1997). Boston: Allyn & Bacon. Also, total scores for both forms of the McGill Pain Questionnairecorrelated well with the visual analog scale and the PPI scale. Vegetarian Times, 233,28-3 . (1995). In order to serve as subjects, patients were required to be womenwith cancer who, at least once, complained of a problem with pain. Health care professionals' familiarity with non-pharmacologicalstrategies for managing cancer pain. Zaza, C., Sellick, S.M., Willan, A., Reyno, L. Third, there are several studies suggesting that meditation is a low-cost effective alternative non-pharmacological strategy for pain controlacross a wide variety of illnesses and injury. However, when it is considered in light of the fact that thereare existing studies showing that in better controlled research, meditationhas been found to reduce pain perceptions, it seems reasonable to believethat this is at least a moderately strong possibility. I would like to assess your pain and discuss an intervention. Findings showed that those in the experimental group evidencedsignificantly greater changes than their controls in terms of: (1)reductions in overall psychological symptomatology and (2) increases inoverall domain-specific sense of control and utilization of an acceptingor yielding mode of control in their lives. The purpose of this study was to examine the use of meditation as anonpharmacological treatment for can pain management. In terms of biophysical and neural processes, it hasgenerally been established that meditation affects brain waves, switchingthem to alpha amplitudes (resting) or even theta waves (completely relaxed)which in turn slows down the body's rhythm and releases endorphines. Significance of the Study Schimpff (1997) refers to alternative, non-pharmacological treatmentsfor pain as "complementary medicine," noting that, in general,complementary medicine consists of approaches to care outside of mainstreammedical practice that are commonly based on traditional practices ofnonwestern cultures. Linton, M. Allsubjects were told about the study in advance and asked to sign informedconsent forms. Dudgeon, D. It had beenhypothesized that participants in the attention-placebo condition would notdemonstrate a significant improvement and findings did confirm thisprediction. Analyses performed on collected data showed that the treatment groupled to improvement in pain severity as well as negative mood, affect, self-control and the interference of pain in the patient's life. Range 58.13 62. Healthcareorganizations must address their employees' spiritual needs. Following participation, experimental subjects were compared withcontrols. According to Scardapane (1999), the findings of the study showed asignificant improvement from pretest to post-test in both the cognitivebehavioral and the mindfulness meditation interventions. Recently, researchers have acknowledged theimportance alternative non-pharmacological treatments for reducing pain. Meditation therapy. Kiess, H.O. Better controlled studies will reveal if this implicationis accurate. Chronic pain management in a healthmaintenance organization. It is recommended here that efforts be made to compile a generalprofile of the effects of meditation across different patient groups--perhaps by conducting a meta analysis--and that the resulting informationbe provided to diverse groups of medical care providers. The response rate was 67 percent (141/214). Analyses of the data showed that respondents were the least familiarwith autogenic training, operant conditioning, and cognitive therapy.Other than radiation and surgery, medical care personnel most commonlyreported recommending support groups. Roth, B. The use of volunteers may meanthat findings are only applicable to the volunteering subset of thepopulation from which subjects were drawn.Setting Montefiore Medical Center is a treatment/teaching facility designedto provide high quality health care and related services to the residentsof the Bronx and southern Westchester County. These efforts should include: the use of a controlgroup, the use of more than one instrument for the assessment of perceivedpain intensity, and if possible, the random selection of subjects from thepopulation as well as their random assignment to the treatment or controlconditions. Further, future researchers may wish to expand the study. The possibility that it is the spiritual aspect of meditation thatproduces the relaxing effect and its subsequent consequence of painreduction is supported at least indirectly by some research. In thisregard, it will be remembered that it was pointed out in an earlier sectionof the study that physicians and other medical care providers are notespecially well informed about alternative pain control techniques such asmeditation. It was hoped that the findings of this study would help tobetter inform medical service providers about this technique. A series of studies published in prestigious medical journals report decreases in pain, anxiety, depression, blood pressure, and other symptoms, allowing physicians to decrease medication and monitor patients less frequently. Research Hypothesis - The use of a mindfulness meditation task willbe effective in significantly reducing the perceived pain intensity ofcancer patients. Hypotheses The review of the literature indicates that meditation has beeneffective, at least in multi-dimensional programs for reducing pain. (199 ). NY: Harcourt BraceJovanovich. Documentavailable: www.hyperion.advanced.org/242 6/meditation-therapy.html. 31). Coward, D.D. Moreover, it is possible that it isprecisely the spiritual component that operates to make the experiencecalming and relaxing. Psychology, 8(2), 99-111.----------------------- 1 Moreover,the age groups as well as the ethnic backgrounds of subjects in this studyvaried considerably and whether or not the variables exerted any influenceover pain perceptions could not really be examined due to the small samplesize. Three hours later they were assessed again fortheir present level of perceived pain intensity using the same testinstrument.FINDINGS Demographic analyses conducted on age and ethnicity data indicatedthat there was strong variance in subjects' ages. However, the instrument is relatively new and in need offurther research before its validity and reliability can be exactlyestablished. (1985). If possible try to sit down and not lie down to prevent going to sleep. Essentially, this was Astin's (1997) conclusion. It seems reasonable to state that one reason why professionals maynot be as informed as they are about alternative treatments such as the useof meditation for cancer pain could be due to a need for more empiricalinvestigations of the technique for cancer. Thesubject patients (N=28) were recruited from the greater Baltimore area andparticipated in eight weekly sessions, 2 1/2 hours each, with threecomponents: an educational component focusing on the mind-body connection,a portion focusing on relaxation response mechanisms (primarily mindfulnessmeditation techniques), and a qigong movement therapy session. (1998). Participants wereassigned to one of the three groups for 8 weekly sessions. Collura, J. Facilitation of self-transcendence in a breastcancer support group. Data were collected from patients in their rooms on the Oncology Wardof Montefiore. Campbell, D.T. Complementary medicine. Only in this way,will information about alternative, nonpharmacologic treatments for pain bedisseminated throughout the medical community. This means that thestudy was absent certain controlsthat allow for an uncontaminated look at the effects of the Treatmentvariable (meditation) on the dependent measure (perceived pain intensity).Specifically, the study's failure to use a control group meant that thepretest itself and not the meditation may be responsible for findings byacting as a stimulus to patients thinking about pain and changing theirperceptions regarding it. Moreover, it needs research that notonly focuses on meditation but specifically on the effects of meditationfor cancer pain. 97) Also, there is in the current research some initial recognition ofthe possibility that it may be the spiritual component of meditation andother alternative forms of treatment that operate to exert a calmingeffect. & Stanley, J.C. Dissertation AbstractsInternational, 6 -B( 1), p. Singh, B.B., Berman, B.M., Hadhazy, V.A. It contains apresent pain intensity (PPI) scale like the long form of the questionnaire,but also includes a visual analog scale. (1997). The term is operationallydefined as subjects PPI scores on the short form of the McGill PainQuestionnaire. It was found that several aspects--sensory, affective, and total scores--correlated well between the shortform and the long form in all three administrations of the questionnaires. Oncology Nursing Forum, 25(1), 75-84. & Dwyer, D. The instrument actually consists ofthree scales: a pain rating index, selection of descriptive words about thepain, and a pain intensity scale. It is hoped thatpositive findings for the technique will assist in fostering moreutilization of this as well as other alternative forms of pain managementin oncology wards. Further, they were arelatively ethnically mixed sample of patients including white, black,hispanic and asian women. & Wolf, J. (1997). Thus, themindfulness meditation group improved on more dependent measures than thecognitive behavioral and attention-placebo groups. Participants in the mindfulness meditation condition demonstrated asignificant improvement on the McGill Pain Questionnaire, the Roland andMorris Disability Questionnaire, the Global Severity Index, the PositiveSymptom Distress Index, as well as the Somatization and Anxiety dimensionsof the SCL-9 . (1997). Therefore, some alternative form of pain control would bepreferred. It uses sensory, affective and evaluativewords to describe the pain experience. Lapin, L. In thisregard, this study looked at a sample of women but future researcher maywish to determine whether findings generalize to a sample of men. Of 64 individuals with chronic pain who participated in this study,39 completed the intervention program. The findings observed for this analysis are presented in Table 1.As can be seen from examination of this table, there was a great deal ofvariance in subjects' ages with a range that covered a spread of 43 years!For this reason, the median is a more accurate picture of the age of thetypical subject than is the mean which is influenced by those at theextreme age ranges. Psychotherapy and Psychosomatics, 66(2), 97-1 6. Men wereexcluded from the study to control for any gender-related responsedifferences. Clearly what is needed in the existing knowledge base is moreresearch such as that conducted by Scardapane (1999), research thatspecifically focuses on meditation. The first recommendation is that future researchersinterested in replicating this study should make efforts to make it moremethodologically sound. ResultsDemographics The first analysis performed on data consisted of descriptivestatistics (calculation of measures of central tendency, variability,frequency and percentages) performed on subjects' demographic data of ageand race. For example,Astin (1997) conducted research which examined the effects of an eight-weekstress reduction program based on training in mindfulness meditation. However, there is evidence that medical care personnel are not awareof these alternative treatments to a significant extent. 99). The ANOVA was preferred over the t-test because it is, essentially, the same procedure (F = t2) but is morerobust with respect to violations of its assumptions which means that theoverall alpha level (. Moreover, it will add to the scientificknowledge base from which conceptual models can be better refined. (Rest ofreference not in supplied materials). A one-way within analysis of variance conducted on subjects' presentpain intensity scores confirmed the research hypothesis. However, Schimpff statesthat often patients obtain these treatments without notifying theirphysicians; in addition, most physicians know little about thesealternative treatment forms. Theywere then taught the mindfulness meditation technique, and asked topractice it for 3 minutes. Purpose Zaza, Sellick, Willan, Reyno and Browman (1999) report that: Many studies have confirmed unnecessary suffering among cancer patients, due to the inadequate use of analgesic medication and other effective interventions. Mindfulness meditation-based stressreduction: Experience with a bilingual inner-city program. Given the forgoing, it can be seen that studying the affects ofmeditation on the perceived pain intensity of cancer patients is a neededstudy that will add to the general knowledge base on the effects ofmeditation on cancer pain. They were randomly assigned to either an experimental group or anonintervention control group. In thisstudy, Scardapane (1999) evaluated the efficacy of a cognitive-behavioralintervention, a mindfulness based stress reduction intervention, and anattention-placebo control for chronic pain management. Itwas noted that previous research efforts suggesting this program may bebeneficial in terms of reducing stress-related symptomatology and helpingpatients cope with chronic pain was limited by a lack of adequatecomparison control group and the author wished to conduct a bettercontrolled study. This means that evenif findings are absolutely valid and reliable, they may only be applicableto the volunteering subset of the population from which subjects weredrawn. (p. Statistics: Meaning and methods. In other words, at best, findings will point to adirection for future, better controlled studies of the effects ofmeditation on the pain management of oncology patients.Procedure Montefiore is a teaching facility and part of its mission statementis to grant permission for students to conduct research. For example, Coward (1998), in a study of the generaleffectiveness of a breast cancer support group designed to facilitate self-transcendence views and perspectives and which included meditation, it wasfound that the group was associated with several positive outcomes.Specifically, it was observed that the group improved members' sense ofself-transcendence as well as emotional well-being. Thus, the research hypothesis was confirmed.CONCLUSIONS It was concluded that due to the pre-experimental nature of thedesign and its attendant methodological failings, all that could be saidwith respect to findings was that they indicate a possible moderatingeffect of meditation on perceived pain intensity. HealthProgress, 79(2), 2 -24. References Alternative Medicine Online. (1975). Stress reduction through mindfulness meditation.Effects on psychological symptomatology, sense of control, and spiritualexperiences. (1999). (1998). These findings weresignificant (F = 12.73; df(1,14); p = . Before a definitiveconclusion about said effects can be made, it will be necessary to conductmore controlled studies.Implications The findings of the study imply that it is possible that mindfulnessmeditation may be used to reduce the perceived levels of pain intensity ofcancer patients. (1999). Thus, the researchproblem examined in this study focused on the use of meditation foralleviating the pain of a sample of cancer patients. Examples of complementary medicine can be said toinclude massage, diet, manipulation, acupuncture and meditation. Unfortunately, thiscannot be firmly concluded despite the fact that the observed findingssupported the research hypothesis concerning pain reduction. Assessing spirituality. It was felt that such astudy would assist in providing physicians and other medical care providerswith a more empirical look at alternative treatments for cancer pain andthat, as a result, they and other medical care personnel would be moreinclined to use these alterative treatments for pain patients in generaland cancer pain patients in particular.HYPOTHESIS The conducted study tested the hypothesis that the level of painintensity subjects were perceiving at present (as measured by PPI scores onthe short form of the McGill Pain Questionnaire) would be significantlyreduced following their practice of a mindfulness meditation technique thatwas taught to them by the researcher.METHODS All subjects (N = 15) in the study were female patients who weredrawn from the female population of the Oncology Ward at MontefioreHospital. One additional recommendation concerns this study's purpose. The Oncology Department provides a wide scope of treatmentto patients with solid tumors or hematologic malignancies. (Astin, 1997, p. While pharmacological treatments are appropriately the central component of cancer pain management, the under-utilization of effective nonpharmacological strategies...may contribute to the problem of pain and suffering among cancer patients. (Scardapane, 1999, p. According to AlternativeMedicine Online (1999), most of these models postulate that meditationappears to quiet the mind, keeping it focused on the present rather than onworries and concerns. Schimpff, S.C. The treatment group participated in a 16-hour, 8-week class teaching cognitive-behavioral techniques, therelaxation response, meditation, and stress management. Pain - As used in the study, this term is conceptually defined as anunpleasant sensory and emotional experience associated with actual orpotential tissue damage (Carriera-Kohlman, 1993). These began with an introduction in which Istated: Hello, my name is Denise Johnson. Basedon the reviewed research, the following hypothesis was formulated fortesting. In this study,the focus on breathing was combined with a mantra consisting of single word(Hamsa) repeated continuously in conjunction with inhaling and exhaling. .51 .7 ----------------------------------------------------------------- ANOVA SUMMARY TABLE-----------------------------------------------------------------SOURCE df SS MS F pTesting 1 3.33 3.33 12.73 . After this,they would told the following: I would now like to show you a technique called meditation. Once subjects had agreed to participate in the study, the basicprotocols were the same. Effects of acceptance-based and cognitivebehavioral interventions on chronic pain management. Only about 43 percent of therespondents had at least heard "something" about the use of meditation formanaging cancer pain. & Creaser, T. The conducted study is important because it supplies atleast a preliminary look at this specific research problem. 359). Thus, it is possiblethat the meditation technique somehow increased the experimental group'sspiritual awareness which, in turn, allowed for a more detached look attheir illness situation providing them with a more effective way of coping. Journal of Pain and Symptom Management, 8, 191-195. What this shows is thatmeditation is, in general, a spiritual practice and cannot be entirely"cleansed" of its spiritual components. 12.74 (75-32) = 43----------------------------------------------------------------- ETHNICITY Frequency PercentCaucasian 5 33.33Hispanic 5 33.33African-American 3 2 . Still, sincethe group contained so many components other than meditation, it isimpossible to determine how much of the improvement in patient outcomes wasspecifically due to meditation practices. According to Schimpff (1997), the literature is showing thatcomplementary medical approaches are being used by many people; indeed, oneestimate is that more than $13 billion is spent annually on complementarymedical techniques in the United States alone. Data collection instruments were the Fibromyalgia ImpactQuestionnaire, the Health Assessment Questionnaire, the Beck DepressionInventory, the Coping Strategies Questionnaire, the helplessness subscaleof the Arthritis Attitudes Index, the Medical Outcomes Study Short FormGeneral Health Survey, and a double-anchored 1 -mm visual analog scale toassess sleep. 359. They may also have potential for relapse prevention in affective disorders. While the foregoing studies offer reason to believe that meditationmay exert an effect on pain, they are also problematic in that theTreatment variable, being multi-dimensional, allowed for no assessment ofthe specific effects of meditation on the outcome measures. It is consideredto be the clinical arm of the Albert Einstein Research Center, an NCI-designated Comprehensive Cancer Center currently conducting over 25 clinical research projects at the local, state and national levels.Design This research used a one-group pretest-posttest design in which allsubjects were first assessed for their perceived intensity of pain.Following this, they were all instructed by the researcher in themeditation technique. Second, relying solely on medication for pain control has a number ofnegative consequences. The short form McGill Pain Questionnaire inchronic cancer pain. The findings observedfor the conducted analysis are presented in Table 2. After this introduction, patients' perceived intensity of pain wasassessed using the short form of the McGill Pain Questionnaire. Subjects were 28 individuals who volunteered to participate in theresearch. (1966). RESEARCH PROJECT Statement of the Problem Despite the prevalence of chronic and other forms of pain, itcontinues to be a challenging problem for the sufferer, family, health careproviders, and society. The center isreally a comprehensive care system that incudes two hospitals, a network ofneighborhood health centers, a wide range of ambulatory specialty services,home health care, rehabilitation and nursing home care. It is hererecommended that future researchers conduct investigations of the spiritualcomponent of meditation to determine the extent to which it may be involvedin decreased perceptions of pain. Definitions So that the undertaken study may be fully understood, the followingkey terms are here defined: Mindfulness Meditation - In general, mediation is conceptuallydefined as a sustained focus on a single object of attention such as a wordor a thought (Roth & Creaser, 1997). Moreover, the experimental subjects also evidenced significantlyhigher scores on a measure of spiritual experiences. SummaryConclusions A key question that can be asked is whether the findings of the studycan be used to definitively conclude that meditation operates to reduceperceived levels of pain intensity in cancer patients? Further,samples were not cancer patients. (1997). That is, subjects'posttest present pain intensity scores were significantly lower than theirpretest scores. Three hours later, I returned to the room and posttested forperceived intensity of pain using the same questionnaire. The particular statistic selectedwas the analysis of variance (ANOVA). Conceptual Framework Why examine whether meditation can be used to reduce pain? 28) In order to fully understand how meditation achieves its effects,several conceptual models have been developed. The short form of the McGill Pain Questionnaire was introduced byDudgeon (1995) in a study of 28 patients with metastatic cancer. What is needed is research that provides anempirical look at complementary medicine, a perspective that physicians cantrust in evaluating whether their patients should seek such treatments.This study is significant because it provides some preliminary informationin this empirical effort to inform the medical community about one of thesealternative treatments. It is the Likert-type scalethat was used in this study; this scale assesses pain intensity as follows: = No Pain 1 = Mild Pain 2 = Discomforting Pain 3 = Distressing Pain 4 = Horrible Pain 5 = Excruciating Pain The Likert-type scale was selected because it allows for dataanalyses using the most powerful statistics, namely parametric statistics(See: Lapin, 199 ; Linton & Gallo, 1975). Specifically, thestudy attempted to determine whether a brief "mindfulness meditationtechnique" reduced the perceived pain intensity of a sample of cancerpatients, all of which were currently patients in the Oncology Ward atMontefiore Hospital. (1998). I am using a word called a mantra which is Hamsa. ABSTRACTPURPOSE The purpose of this study was to investigate the impact of meditationon the perceived pain intensity of cancer patients. & Bloomquist, D.W. For example, Bazan and Dwyer (1998) recommend that HMOS and otherorganizations begin to develop specific programs and strategies that aredirectly aimed at meeting patients' spiritual needs. Behavioral outcomes,function, and pain severity and also patient satisfaction were measured bythe authors. Because of the pre-experimental nature of this study, it must beconsidered that it provided only a preliminary or tentative description ofthe possible effects of meditation on cancer pain. The table also shows that the subject group wasethnically diverse; however, most of the women were either Hispanic orwhite.Hypothesis Testing A one-way within subjects analysis of variance was conducted toexamine whether subjects' total posttest pain scores wereTable 1Findings Observed For Descriptive Analyses Conducted On Age and RaceDemographics_________________________________________________________________ AGE Mean Median S.D. The practical statistician:Simplified handbook of statistics. Chicago: Rand McNally. The study used a pre-experimental, one-group, pretest-posttest designin which subjects were first assessed for their present level of perceivedpain intensity using the short form of the McGill Pain Questionnaire. After this instruction, subjects were told to practice the techniquefor abut 3 minutes and that I would return and see them in around threehours. Instrumentation This study's assessment of perceived intensity of pain consisted ofsubjects' mean total score on the short form of the McGill Pain AssessmentQuestionnaire (Dudgeon, 1995). Scardapane, J.R. I am a registered nurse who is a graduate student at Lehman College. The zen of pain control. A similar program was tested by Singh, Berman, Hadhazy and Creamer(1998) for patients suffering from fibromyalgia (a syndrome characterizedby widespread musculoskeletal pain and multiple tender points as well ashigh levels of self-reported disability and poor quality of life). & Browman, G.P.(1999). For example, in one study, McCarberg and Wolf(1999) studied a multi-dimensional cognitive-behavioral program (acomponent of which was meditation) to reduce the pain of a sample of HMOpatients who had failed all known pain treatment regimens and had been insevere pain for six months. Several subjects in the study expressedconcerns that the meditation technique was in accord with their spiritualvalues; other subjects, actually changed the word used so as to use a wordthat was in accord with their spiritual beliefs (i.e., one woman focused onthe word "God" as she inhaled and exhaled). According to Campbell and Stanley (1996),the one-group pretest-posttest design is a pre-experimental design becauseof its lack of a control group which fails to control for the possibilitythat the pretest serves as a stimulus to response change by sensitizingsubjects to the dependent measure (perceived intensity of pain). Experimental and quasi-experimental designs for research. Thus, findings were inaccord with the predicted hypothesis of the study. In this regard, Collura(1997) has stated that meditation (of the form used in this research): ...has attracted the attention of medical researchers and spawned over 1 hospital-based programs across the country. These related toimproving the research design, investigating the spirituality component ofmeditation, and helping medical care personnel become more aware ofalternative treatments. As the researcher put it: The techniques of mindfulness meditation, with their emphasis on developing detached observation and awareness of the contents of consciousness, may represent a powerful cognitive coping strategy for transforming the ways in which we respond to life events. Researchersconcluded that the instrument was a useful tool for studying chronic painand interventions in cancer patients, and would be particularly of useamong patients with limited concentration abilities. The long form of the instrument was designedto provide a quantitative measure of clinical pain that yields data thatcan be treated statistically. Moreover, the short form of the McGill Pain Questionnaire isTable 2Cell Means and ANOVA Summary Findings Observed For One-Way, Within-SubjectsANOVA Examining Perceived Pain Intensity Scores at two levels of Testing_________________________________________________________________ TESTING Pretest PosttestMean 3.6 2.93S.D. As more and more studies areundertaken and published in the medical journals, medical service deliverypeople will become more aware of their effectiveness. The minimaltreatment group received a home-study manual. Current Opinions inOncology, 9(4), 327-331. Asian 2 13.34__________________________________________________________________________________________________________________________________significantly lower than their pretest pain scores. Therefore studies that examine the morespiritual components of alternative pain management strategies may assistin these new efforts to adapt care and treatment to patients' spiritualneeds and concerns.Recommendations Several recommendations may be formulated on the basis of thisstudy's findings. The controlgroup also made some gains in this area but not as strong gains. Based on the foregoing findings, Scardapane (1999) recommended that: Future research could examine ways of enhancing the effectiveness of the mindfulness meditation treatment and more directly compare it to the traditional cognitive behavioral approach. Monterey, CA: Brooks/Cole. 31Subjects 14 6.87 .49 1.87Error 14 3.66 .26-----------------------------------------------------------------TOTAL 29 13.86__________________________________________________________________________________________________________________________________considered to have a positive profile in those psychometric studies thathave conducted. Over the years, several studies have indicated thatvolunteer subjects are a qualitatively different population that non-volunteers. However, before strongconfidence can be placed in this conclusion, it will be necessary toconduct research that is more methodologically controlled.RECOMMENDATIONS Recommendations were made to future researchers. I will assure you that in no way will this interfere with any present or future treatment or medications that you are or will receive. Further, patients reported that their pain had decreased and whatpain they felt was much less intrusive in their daily lives. For example, in astudy of medical care personnel's knowledge of alternative,nonpharmacological treatment for cancer pain, Zaza, Sellick, Willan, Reynoand Browman (1999) surveyed 214 health care professions regarding 11alternative strategies for pain reduction (i.e., guided imagery,acupuncture and so forth). AlternativeTherapy Health Medicine, 4(2), 67-7 . Therefore, the instrument used to measure the study'sdependent variable is also a bit problematic. First, itneeds to be noted that the level of pain experienced by cancer patients isoften severe (Zaza, Sellick, Willan, Reyno & Browman, 1999). What makes it difficult to place strong confidence in the notion thatmeditation is a moderator of pain for cancer patients is the fact that theconducted research was pre-experimental in nature. (p. With respect to the foregoing, the authors note that, in general,healthcare organizations can, through their structures and culture, createenvironments that promote meeting patients spiritual needs and helping themdeal with spiritual concerns. Participants in the cognitive behavioralgroup demonstrated a significant improvement on the Melzack PainQuestionnaire and on the Significant Other Pain Questionnaire. Review of the Literature There have been several studies suggesting that meditation canoperate to reduce pain. The study used a pretest-posttestdesign in which dependent measures were administered before and after eachintervention. (1999). Astin, J.A. For example, Kiess and Bloomquist (1985) report that volunteerstend to be more sociable, more knowledgeable, more respectful of scientificresearch, and less conventional than non-volunteers. Only those subjects agreeing to participate and signing theforms served as subjects in the study. Eight of the patients had to drop out of the study; however,the 2 who remained throughout the entire program showed strong reductionsin pain as well as in their level of fatigue and sleeplessness. Thisinstrument has only 15 worddescriptors compared to the 78 descriptors of the long form. Now I would like to assess your pain. & Gallo, P.S. Three hours later, patients were again assessed forperceived intensity of pain. al (1999) report thatlimiting pain control to medication can lead to serious side effects,possible interactions with other medications patients are taking, and canbe very costly. Specifically, it was foundthat posttest pain intensity scores (Mean = 2.93) were significantly lowerthan pretest pain intensity scores (Mean =3.6 ). All that wasrequired was permission from my preceptor and the completion of formsexplaining the study and the various methods it would require. It also treats personsreferred from places throughout New York and the nation. Apilot study of cognitive behavioral therapy in fibromyalgia. It is the pain intensity scale thatserves as this study's dependent measure. Further,the failure of the design to randomly select subjects from the populationmeans that the same may not be representative. When comparing the efficacy of mindfulness meditation with cognitivebehavioral therapy, only participants in the mindfulness meditationcondition significantly improved on the Somatization dimension and PositiveSymptom Distress Index of the SCL-9 , as well as on the Interference andAffective Distress scales of the Multidimensional Pain Inventory. 5) remains relatively stable even when there areextreme violations of its underlying assumptions (Linton & Gallo, 1975). Clinical Journal of Pain, 15(1), 5 -57. There is a second implication of this study that concerns thespiritual aspect of meditation. As you inhale, silently repeat "Ham." As you exhale, silently repeat "sa." If other thoughts occur, just return to repeating these words. Bazan, W. In addition, an improvement was detected on the PainSeverity, Interference, and Affective Distress scales of theMultidimensional Pain Inventory. The sample was not randomly selected because: a) some patients on theward were too ill to participate; and b) no one was forced to participateso only those that volunteered were used. It is better if you do this when it is quiet, without the television or radio on. You close your eyes. Moreover,without some form of pain reduction, these patients are likely toexperience heightened anxiety, depression, somatic focusing, neuroticismand physical deterioration (Zaza, Sellick, Willan, Reyno & Browman, 1999).Thus, using some method of pain reduction is imperative. Further, because of ethical considerations, it was necessary to usevolunteer subjects. The researcher was granted access to OncologyWard patients because her preceptor requested it and it is a teachinghospital willing to grant such access to its students. In this regard, Zaza et. Data Analysis The short form of the McGill Pain Questionnaire measures a variety ofdifferent types of pain (throbbing, stabbing, etc.) at sensory, affectiveand physical levels using two intensity scales, one of which is a semanticdifferential scale and the other of which is a Likert-type scale(behaviorally anchored, summated rating scale). Because of the lack of control associated with this design, thefindings of the study---however informative---should be consideredpreliminary in nature. Another recommendation for future researchers concerns the notion ofmeditation having a spiritual component which may be of influence in termsof the relaxing or calming effects of meditation techniques. Even in studies that have used meditation for the treatment of cancerpatients, the meditation component has always been included as one ofmultiple components. & Creamer, P. There has been one very recent study that took a more precise look atthe effects of the meditation component in terms of reducing pain. Further,their general function improved as did their basic health and mood state.
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