Immediate stress reduction effects of yoga during pregnancy: One group pre-post test.

Kusaka M, Matsuzaki M, Shiraishi M, Haruna M

Women Birth. 2016 Oct;29(5):e82-e88

Excessive stress during pregnancy may cause mental disorders in pregnant women and inhibit fetal growth. Yoga may alleviate stress during pregnancy.

AIM: To verify the immediate effects of yoga on stress response during pregnancy.

METHODS: One group pre-post test was conducted at a hospital in Japan. We recruited 60 healthy primiparas without complications and asked them to attend yoga classes twice a month and to practice yoga at their homes using DVD 3 times a week from 20 gestational weeks until childbirth. Salivary cortisol and alpha-amylase concentration were measured before and after yoga classes at time 1 (27-32 gestational weeks) and time 2 (34-37 gestational weeks). Subjective mood was assessed using the profile of mood states. Saliva values and mood scores before and after each yoga class were compared using paired t-test and Wilcoxon rank-sum test, respectively.

FINDINGS: We analyzed 44 and 35 women at time 1 and time 2, respectively. The mean salivary cortisol concentration declined significantly after each yoga class [time 1: 0.36-0.26μg/dL (p<0.001), time 2: 0.32-0.26μg/dL (p=0.001)]. The mean salivary alpha-amylase concentration also decreased significantly following each class [time 1: 72.2-50.8kU/L (p=0.001), time 2: 70.6-52.7kU/L (p=0.006)]. The scores for negative dimensions of mood (Trait-Anxiety, Depression, Anger-Hostility, Fatigue, and Confusion) decreased significantly. The scores of Vigor for a positive dimension of mood significantly increased.

CONCLUSION: This study indicated the immediate stress reduction effects of yoga during pregnancy.

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Operationalizing the Measuring What Matters Spirituality Quality Metric in a Population of Hospitalized, Critically Ill Patients and Their Family Members.

Aslakson RA, Kweku J, Kinnison M, Singh S, Crowe TY, AAHPM Writing Group
J Pain Symptom Manage. 2016 Dec 29;:

Measuring What Matters (MWM) quality indicators support measurement of the percentage of patients who have spiritual discussions, if desired.

OBJECTIVES: To 1) determine the ease of, and barriers to, prospectively collecting MWM spirituality quality measure data and 2) further explore the importance of spirituality in a seriously ill, hospitalized population of critically ill patients and their family members.

METHODS: Electronic medical record (EMR) review and cross-sectional survey of ICU patients and their family members from October-December 2015. Participants were in four adult intensive care units totaling 68 beds at a single academic, urban, tertiary care center which has ICU-assigned chaplains and an in-house, 24-hour, on-call chaplain.

RESULTS: All patients had a "Spiritual Risk Screen" which included two questions identifying patient religion and whether a chaplain visit was desired. Approximately 2/3 of ICU patients were eligible and there were 144 respondents (50% female; 57% patient and 43% family member), with the majority being Caucasian or African American (68% and 21%, respectively). Common religious identifications were Christian or no faith tradition (76% and 11%, respectively). Approximately half of patients had an EMR chaplain note though it did not document presence of a "spiritual discussion". No study patients received palliative care consultation. A majority (85%) noted that spirituality was "important to them" and that prevalence remained high across respondent age, race, faith tradition, or admitting ICU.

CONCLUSION: Operationalizing the MWM spirituality quality indicator was challenging as elements of a "spiritual screening" or documentation of a "spiritual discussion" were not clearly documented in the EMR. The high prevalence of spirituality among respondents validates the importance of spirituality as a potential quality metric.

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