Cognition

Improve Cognitive Ability in Older Adults with Tai Chi and Qigong Practices

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Improve Cognitive Ability in Older Adults with Tai Chi and Qigong Practices

 

By John M. de Castro, Ph.D.

 

“Qigong exercise induced significant neurocognitive improvement in aging.” – Di Qi

 

The aging process involves a systematic progressive decline in every system in the body, the brain included. The elderly frequently have problems with attention, thinking, and memory abilities, known as mild cognitive impairment. An encouraging new development is that mindfulness practices such as meditation training and mindful movement practices can significantly reduce these declines in cognitive ability.

 

Tai Chi and Qigong have been practiced for thousands of years with benefits for health and longevity. Tai Chi and Qigong trainings are designed to enhance function and regulate the activities of the body through regulated breathing, mindful concentration, and gentle movements. Tai Chi and Qigong practice have been found to be effective for an array of physical and psychological issues. Tai Chi and Qigong have been shown to help the elderly improve attention, balance, reducing falls, arthritis, cognitive function, memory, and reduce age related deterioration of the brain. The research findings have been accumulating suggesting that a summarization of what has been learned about the effects of Tai Chi and Qigong practice on the cognitive ability of older adults is called for.

 

In today’s Research News article “Effects of Chinese Mind-Body Exercises on Executive Function in Middle-Aged and Older Adults: A Systematic Review and Meta-Analysis.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2021.656141/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1645362_69_Psycho_20210525_arts_A ) Ren and colleagues review, summarize, and perform a meta-analysis of the published research on the effects of Tai Chi and Qigong practice on the cognitive ability of older adults. They identified 29 published randomized controlled trials employing participants over 50 years of age.

 

They report that the published research found that Tai Chi and Qigong practice produced significant increases in overall executive function including improvements in short-term memory and shifting, the ability to shift from attentional focus to attentional focus. They also found that when practice occurred 5 or more times per week, the effects doubled compared to practice less than 4 times per week.

 

The findings suggest that Tai Chi and Qigong practices are effective in improving thinking in older adults. Since cognitive abilities tend to decline with age, the results suggests that Tai Chi and Qigong practice may protect against age related cognitive decline. This is true especially when practice occurs 5 or more times per week.

 

Some advantages of Tai Chi and Qigong include the facts that they are not strenuous, involve slow gentle movements, are safe, having no appreciable side effects, and are appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion. It can also be practiced without professional supervision and in groups making it inexpensive to deliver and fun to engage in. This makes Tai Chi and Qigong practice excellent practices for protecting older individuals from age related cognitive decline.

 

So, improve cognitive ability in older adults with Tai Chi and Qigong practices.

 

“Tai chi appears to improve executive function—the ability to multitask, manage time, and make decisions—in people without any cognitive decline. In those with mild cognitive impairment, tai chi slowed the progression to dementia more than other types of exercise and improved their cognitive function in a comparable fashion to other types of exercise or cognitive training.” – Havard Health

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Ren F-F, Chen F-T, Zhou W-S, Cho Y-M, Ho T-J, Hung T-M and Chang Y-K (2021) Effects of Chinese Mind-Body Exercises on Executive Function in Middle-Aged and Older Adults: A Systematic Review and Meta-Analysis. Front. Psychol. 12:656141. doi: 10.3389/fpsyg.2021.656141

 

Chinese mind-body exercises (CMBEs) are positively associated with executive function (EF), but their effects on EF, from synthesized evidence using systematic and meta-analytic reviews, have not been conducted. Therefore, the present systematic review with meta-analysis attempted to determine whether CMBEs affect EF and its sub-domains, as well as how exercise, sample, and study characteristics moderate the causal relationship between CMBEs and EF in middle-aged and older adults. Seven electronic databases were searched for relevant studies published from the inception of each database through June 2020 (PubMed, Web of Science, Embase, Cochrane Controlled Trials Register, Wanfang, China National Knowledge Infrastructure, and Weipu). Randomized controlled trials with at least one outcome measure of CMBEs on EF in adults of mean age ≥ 50 years with intact cognition or mild cognitive impairment (MCI) and with or without chronic diseases were included. A total of 29 studies (N = 2,934) ultimately were included in this study. The results indicated that CMBEs improved overall EF (Standardized Mean Differences = 0.28, 95% CI 0.12, 0.44), as well as its sub-domains of working memory and shifting. The beneficial effects of CMBEs on EF occurred regardless of type (Tai Chi, Qigong), frequency of group classes (≤2 time, 3-4 time, ≥5 times), session time (≤45 min, 46-60 min), total training time (≥150 to ≤300 min, >300 min), and length of the CMBEs (4-12 week, 13-26 week, and >26 week), in addition to that more frequent participation in both group classes and home practice sessions (≥5 times per week) resulted in more beneficial effects. The positive effects of CMBEs on EF were also demonstrated, regardless of participants mean age (50-65 years old, >65 years old), sex (only female, both), and cognitive statuses (normal, MCI, not mentioned), health status (with chronic disease, without chronic disease), as well as training mode (group class, group class plus home practice) and study language (English, Chinese). This review thus suggests that CMBEs can be used as an effective method with small to moderate and positive effects in enhancing EF, and that more frequent group classes and home practice sessions may increase these effects. However, certain limitations, including strictly design studies, limited ES (effect size) samples for specific variables, and possible biased publications, required paying particular attention to, for further exploring the effects of CMBEs on EF.

https://www.frontiersin.org/articles/10.3389/fpsyg.2021.656141/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1645362_69_Psycho_20210525_arts_A

 

Improve Cognition and Performance in 3rd Grade Children with Mindfulness

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Improve Cognition and Performance in 3rd Grade Children with Mindfulness

 

By John M. de Castro, Ph.D.

 

“The Collaborative for Academic, Social, and Emotional Learning (CASEL) has linked mindfulness to two core social-emotional skills: self-regulation and self-awareness. Skills in these areas teach students not only how to recognize their thoughts, emotions, and actions, but also how to react to them in positive ways.” – Waterford.org

 

Childhood is a miraculous period during which the child is dynamically absorbing information from every aspect of its environment. This is particularly evident during the elementary school years. Mindfulness training in school has been shown to have very positive effects. These include improvements in the academic, cognitive, psychological, and social domains. Training early in childhood has the potential of jump-starting the child’s academic performance.

 

In today’s Research News article “Promoting Third Graders’ Executive Functions and Literacy: A Pilot Study Examining the Benefits of Mindfulness vs. Relaxation Training.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2021.643794/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1645362_69_Psycho_20210525_arts_A )  Cordeiro and colleagues recruited 3rd grade students and randomly assigned them to receive 2 30-minute sessions per week for 8 weeks of either mindfulness training or progressive muscle relaxation training. They were measured before and after training for non-verbal intelligence, short-term memory, inhibitory control, and cognitive flexibility, teacher ratings of the child’s short-term memory, inhibitory control, and cognitive flexibility, handwriting fluency, spelling, essay quality, and school grades.

 

They found that for children low in executive function, relaxation training produced significantly greater improvement in executive function while students high in executive function, mindfulness training produced significantly greater improvement in executive function. Further, in children high in cognitive flexibility mindfulness training produced significantly greater improvement in cognitive flexibility. Finally, they found that mindfulness training produced significantly greater improvements in handwriting fluency and school grades than relaxation training.

 

The results were not as straightforward as one might like but still are interesting. They suggest that mindfulness training of 3rd grade students produces cognitive improvements in the students with the greatest cognitive ability to start with and significantly greater improvements in grades and handwriting fluency in all students. It should be noted that there was no follow-up beyond the end of training, so it is not known if the benefits of mindfulness training persist longer than immediately after training.

 

It has been demonstrated in previous research that mindfulness training produces improvement in cognition and school performance. The results of the present study suggest that mindfulness training is beneficial for young children in the 3rd grade improving their thinking ability and school performance. Early interventions in children’s lives and school performance have the potential of producing greater achievements as the child progresses through school. It remains for future research to determine the long-term effects of early mindfulness training.

 

So, improve cognition and performance in 3rd grade children with mindfulness.

 

“Mindfulness applies to nearly every part of life. It includes everything from mindful commuting, to being mindful of what we eat (and how it smells and tastes) to being mindful of opportunities to sneak in some physical activity – or rest – during our busy days. And for adults, a good place to start learning the art of mindfulness is from these third graders!” – Health Partners

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Cordeiro C, Magalhães S, Rocha R, Mesquita A, Olive T, Castro SL and Limpo T (2021) Promoting Third Graders’ Executive Functions and Literacy: A Pilot Study Examining the Benefits of Mindfulness vs. Relaxation Training. Front. Psychol. 12:643794. doi: 10.3389/fpsyg.2021.643794

 

Research suggested that developing mindfulness skills in children improves proximal outcomes, such as attention and executive functions, as well as distal outcomes, such as academic achievement. Despite empirical evidence supporting this claim, research on the benefits of mindfulness training in child populations is scarce, with some mixed findings in the field. Here, we aimed to fill in this gap, by examining the effects of a mindfulness training on third graders’ proximal and distal outcomes, namely, attention and executive functions (viz., inhibitory control, working memory, and cognitive flexibility) as well as literacy-related achievement (viz., handwriting fluency, text quality, Portuguese grades). These outcomes were measured with behavioral tasks and teacher ratings. Sixty-six Portuguese children were randomly allocated to an experimental group receiving mindfulness training (n = 29) or an active control group receiving relaxation training (n = 37). Both training programs were implemented by psychologists in two 30-min weekly sessions for 8 weeks. All students were assessed before and after the interventions. Three main findings are noteworthy: (a) mindfulness training enhanced teacher-rated cognitive flexibility and a performance-based composite score of executive functions among children with higher pretest scores; (b) relaxation training improved performance-based cognitive flexibility and the composite score of executive functions among children with lower pretest scores; (c) children receiving mindfulness training had higher handwriting fluency and better grades in Portuguese than those receiving relaxation training. These findings provide preliminary evidence on the benefits of mindfulness training in educational settings and highlight the moderating role of baseline performance on those benefits.

https://www.frontiersin.org/articles/10.3389/fpsyg.2021.643794/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1645362_69_Psycho_20210525_arts_A

 

Tai Chi Practice Improves the Symptoms of Multiple Diseases

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Tai Chi Practice Improves the Symptoms of Multiple Diseases

 

By John M. de Castro, Ph.D.

 

“In addition to easing balance problems, and possibly other symptoms, tai chi can help ease stress and anxiety and strengthen all parts of the body, with few if any harmful side effects.” Peter Wayne

 

Tai Chi is an ancient mindfulness practice involving slow prescribed movements. It is gentle and completely safe, can be used with the elderly and sickly, is inexpensive to administer, can be performed in groups or alone, at home or in a facility or even public park, and can be quickly learned. In addition, it can also be practiced in social groups without professional supervision. This can make it fun, improving the likelihood of long-term engagement in the practice. Indeed, studies have shown that Tai Chi practice is effective in improving the symptoms of many different diseases. The evidence is accumulating. So, it makes sense to step back and summarize what has been learned about the effectiveness of different Tai Chi practices for different disease conditions.

 

In today’s Research News article “.Clinical Evidence of Tai Chi Exercise Prescriptions: A Systematic Review” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7972853/ ) Huang and colleagues review and summarize the published randomized controlled trials on the effectiveness of different Tai Chi practices for different disease conditions. They identified 139 published randomized controlled trials utilizing a number of different Tai Chi styles and numbers of forms. Yang style was by far the most frequent style and 24 forms was the most frequent number of forms employed.

 

They report that the published research found that Tai Chi practice produced significant improvement in the symptoms of musculoskeletal system or connective tissue diseases such as osteoarthritis, fibromyalgia, and chronic low back pain.; on circulatory system diseases such as hypertension, stroke, coronary heart disease, and chronic heart failure; on mental and behavioral disorders such as depression, cognitive impairment, and intellectual disabilities; on nervous system diseases such as Parkinson’s disease, dementia, and sleep disorders; on chronic obstructive pulmonary disease (COPD); on endocrine, nutritional, or metabolic diseases such as type 2 diabetes and metabolic syndrome; on the physical and mental state of cancer patients, and on traumatic brain injury and urinary tract disorders; on balance control and flexibility and falls in older adults.

 

These are remarkable findings. Tai Chi practice appears to be a safe and effective treatment for the symptoms of a wide variety of diseases. It doesn’t cure the disease. Rather if alleviates the symptoms. It is not known the mechanisms by which Tai Chi has these benefits. Future research needs to further explore what facets or effects of Tai Chi practice are responsible for the disease symptom improvements.

 

So, Tai Chi practice improves the symptoms of multiple diseases.

 

“Tai Chi and Qigong are evidence-based approaches to improve health-related quality of life, and they may be effective for a range of physical health conditions.” – Ryan Abbott

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Huang, J., Wang, D., & Wang, J. (2021). Clinical Evidence of Tai Chi Exercise Prescriptions: A Systematic Review. Evidence-based Complementary and Alternative Medicine : eCAM, 2021, 5558805. https://doi.org/10.1155/2021/5558805

 

Abstract

Objectives

This systematic review aims to summarize the existing literature on Tai Chi randomized controlled trials (RCTs) and recommend Tai Chi exercise prescriptions for different diseases and populations.

Methods

A systematic search for Tai Chi RCTs was conducted in five electronic databases (PubMed, Cochrane Library, EMBASE, EBSCO, and Web of Science) from their inception to December 2019. SPSS 20.0 software and Microsoft Excel 2019 were used to analyze the data, and the risk of bias tool in the RevMan 5.3.5 software was used to evaluate the methodological quality of RCTs.

Results

A total of 139 articles were identified, including diseased populations (95, 68.3%) and healthy populations (44, 31.7%). The diseased populations included the following 10 disease types: musculoskeletal system or connective tissue diseases (34.7%), circulatory system diseases (23.2%), mental and behavioral disorders (12.6%), nervous system diseases (11.6%), respiratory system diseases (6.3%), endocrine, nutritional or metabolic diseases (5.3%), neoplasms (3.2%), injury, poisoning and certain other consequences of external causes (1.1%), genitourinary system diseases (1.1%), and diseases of the eye and adnexa (1.1%). Tai Chi exercise prescription was generally classified as moderate intensity. The most commonly applied Tai Chi style was Yang style (92, 66.2%), and the most frequently specified Tai Chi form was simplified 24-form Tai Chi (43, 30.9%). 12 weeks and 24 weeks, 2-3 times a week, and 60 min each time was the most commonly used cycle, frequency, and time of exercise in Tai Chi exercise prescriptions.

Conclusions

We recommend the more commonly used Tai Chi exercise prescriptions for different diseases and populations based on clinical evidence of Tai Chi. Further clinical research on Tai Chi should be combined with principles of exercise prescription to conduct large-sample epidemiological studies and long-term prospective follow-up studies to provide more substantive clinical evidence for Tai Chi exercise prescriptions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7972853/

 

Decrease Aging Cognitive Decline with Qigong Practice

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Decrease Aging Cognitive Decline with Qigong Practice

 

By John M. de Castro, Ph.D.

 

“various activities such as Qi Gong, Tai Chi, Meditation, Yoga, Pranayama (breath work) and more can slow down the aging process and also reverse DNA damage.” – Beyond Spiritual Healing

 

The aging process involves a systematic progressive decline in every system in the body, the brain included. The elderly frequently have problems with attention, thinking, and memory abilities, known as mild cognitive impairment. An encouraging new development is that mindfulness practices such as meditation training and mindful movement practices can significantly reduce these declines in cognitive ability. In addition, it has been found that

mindfulness practices reduce the deterioration of the brain that occurs with aging restraining the loss of neural tissue. Indeed, the brains of practitioners of meditation,  yoga, and Tai Chi have been found to degenerate less with aging than non-practitioners.

 

Qigong has been practiced for thousands of years with benefits for health and longevity. Qigong training is designed to enhance function and regulate the activities of the body through regulated breathing, mindful concentration, and gentle movements. Qigong  practice has been found to be effective for an array of physical and psychological issues. Qigong has been shown to help the elderly improve attention, balance, reducing falls, arthritis, cognitive function, memory, and reduce age related deterioration of the brain. So, it makes sense to further study the ability of Qigong training to reduce cognitive decline in the elderly.

 

In today’s Research News article “Effect of 1 Year of Qigong Exercise on Cognitive Function Among Older Chinese Adults at Risk of Cognitive Decline: A Cluster Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2020.546834/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1473550_69_Psycho_20201103_arts_A ) Jin and colleagues recruited healthy elderly adults, over 60 years of age, who did not engage in any mind-body practices like Qigong and randomly assigned them to receive either Qigong practice or stretching practice. Each intervention had 3 weekly training sessions followed by 1-year of at least twice a week 60-minute practice guided with videos and included once a month refresher training. The participants were measured before and after training for cognitive performance and neuropsychological performance.

 

They found that compared to baseline and the stretching group the Qigong participants had significantly higher cognitive performance after the year’s practice including memory, visuospatial ability, and language ability. The number of Qigong participants who were classified as having a mild cognitive impairment declined over the year while the stretching group did not.

 

These results suggest that Qigong practice improves cognitive ability and reduces cognitive decline in the elderly. Age related cognitive is inevitable and greatly reduces the abilities and quality of life of the elderly. Reducing the decline should contribute to greater well-being in aging individuals.

 

These findings suggest that Tai Chi practice is a safe and effective method to reduce the decline in thinking ability with aging. But the story is even better. Qigong is not strenuous, involves slow gentle movements, and is safe, having no appreciable side effects, it is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion. It can also be practiced without professional supervision and in groups making it inexpensive to deliver and fun to engage in. This suggests that Qigong practice should be recommended for the elderly.

 

So, decrease aging cognitive decline with Qigong practice.

 

“Qigong can complement Western medicine in many ways to provide better healthcare. For example, qigong has special value for treating chronic conditions and as a preventive medicine, whereas Western medicine has special value for treating acute conditions.” – Qigong Institute

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Jin J, Wu Y, Li S, Jin S, Wang L, Zhang J, Zhou C, Gao Y and Wang Z (2020) Effect of 1 Year of Qigong Exercise on Cognitive Function Among Older Chinese Adults at Risk of Cognitive Decline: A Cluster Randomized Controlled Trial. Front. Psychol. 11:546834. doi: 10.3389/fpsyg.2020.546834

 

ABSTRACT

Background: The rapidly aging Chinese population is showing an increase in age-related illnesses, including mild cognitive impairment and Alzheimer disease. The best types of physical activity for the improvement of cognition remain unknown. This study aimed to compare the effectiveness of a tailored qigong exercise with that of stretching exercise in the maintenance of cognitive abilities in Chinese elders at risk of cognitive decline.

Methods: Seventy-four community-dwelling adults aged ≥60 years were screened for eligibility. Using a randomized control group design, participants with scores ≥19 on the Chinese version of the Montreal Cognitive Assessment-Basic (MoCA) were allocated to a 1-year qigong intervention (n = 33) and a stretching control exercise group (n = 33). The primary outcome was the MoCA score, as a measure of global cognitive function, and secondary outcomes were globe cognition and five domain scores on the Chinese version of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). The MoCA and RBANS were administered at baseline and 1 year after intervention to assess the effect of the exercises on cognitive decline.

Results: Twenty-five of 33 (75.8%) participants in the qigong group and 26 of 33 (78.8%) participants in the control group completed the 1-year exercise programs. A bivariate test revealed strong correlation between MoCA and RBANS total scores after the intervention (r = 0.517, p < 0.01). Generalized estimating equations revealed a lower risk of progression of cognitive decline at 1 year in the qigong group than in the control group (odds ratio, 0.314; 95% confidence interval, 0.103–0.961; p = 0.04). Two-way repeated-measures ANOVA followed by post hoc t tests with Bonferroni corrections indicated that MoCA and RBANS scores were significantly higher in the qigong group than in the control group (MoCA and RBANS global cognition, memory, visuospatial/constructional ability, and language, all p < 0.01), with the exception of RBANS attention score (p > 0.05).

Conclusions: One year of qigong practice was significantly superior to stretching exercise not only for the prevention of cognitive decline progression, but also for the improvement of several cognitive functions, among older Chinese adults at risk of cognitive decline.

https://www.frontiersin.org/articles/10.3389/fpsyg.2020.546834/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1473550_69_Psycho_20201103_arts_A

 

Become a Better Athlete with Mindfulness

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Become a Better Athlete with Mindfulness

 

By John M. de Castro, Ph.D.

 

“athletes perform better when experiencing flow and that mindfulness meditation for athletes can help them experience flow. This is really good news for high-performance coaches and athletes.” – Ertheo

 

Athletic performance requires the harmony of mind and body. Excellence is in part physical and in part psychological. That is why an entire profession of Sports Psychology has developed. “In sport psychology, competitive athletes are taught psychological strategies to better cope with a number of demanding challenges related to psychological functioning.” They use a number of techniques to enhance performance including mindfulness training. It has been shown to improve attention and concentration and emotion regulation and reduces anxiety and worry and rumination, and the physiological and psychological responses to stress. As a result, mindfulness training has been employed by athletes and even by entire teams to enhance their performance.

 

In today’s Research News article “Mindfulness Training Enhances Endurance Performance and Executive Functions in Athletes: An Event-Related Potential Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7474752/ ) Nien and colleagues explored the effects of mindfulness training on college athletes. They recruited healthy college athletes who had no experience with mindfulness training and randomly assigned them to either receive mindfulness training or to a wait-list control condition. Mindfulness training consisted of 2 30-minute training sessions per week for 5 weeks and included mindful breathing, mindful meditation, body scanning, mindful yoga, and mindful walking. They were measured before and after the 5-week training period for athletic endurance, cognitive function (Stroop task), and mindfulness. The Stroop Task measures attention, response speed, and behavioral inhibition.

 

To measure the nervous systems processing of information, the electroencephalogram (EEG) was recorded and evoked potentials to the stimuli onsets were measured during the Stroop Task. They focused on the N2 response in the evoked potential which is a negative going electrical response in the EEG occurring between a 2.0 to 3.5 tenths of a second following the target stimulus presentation. The N2 component is thought to reflect attentional monitoring of conflict and inhibitory control.

 

They found that in comparison to baseline and the wait-list control group, the athletes who received mindfulness training had significant increases in mindfulness, athletic endurance, and attention and behavioral inhibition accuracies on the Stroop cognitive task. They also found that the mindfulness trained athletes had significantly lower N2 responses in the evoked potential.

 

These are interesting findings but conclusions must be tempered with the knowledge that the comparison condition was passive. This opens the possibility of alternative explanations such as participant expectancy, attention, or bias effects. Nevertheless, the results suggest that mindfulness training improves the athlete’s executive function and endurance. The results of both the Stroop Task and the N2 component of the evoked potential are compatible as each measures the ability to inhibit responses in the face of informational conflict.

 

The mechanisms by which mindfulness training has these effects was not explored in the present study. But previous research has demonstrated that mindfulness training improves executive function including behavioral inhibition. Additionally, previous research has demonstrated that mindfulness training improves the physiological and psychological responses to stress. These improved responses to stress may well explain the increased athletic endurance observed in the mindfulness training athletes as endurance measures the individual’s ability to maintain function under stress.

 

So, become a better athlete with mindfulness.

 

“Focus and attention, body awareness and the ability to immerse yourself in the present moment – these are skills in both high-level athletic performance and mindfulness meditation.” – Dave Charny

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Nien, J. T., Wu, C. H., Yang, K. T., Cho, Y. M., Chu, C. H., Chang, Y. K., & Zhou, C. (2020). Mindfulness Training Enhances Endurance Performance and Executive Functions in Athletes: An Event-Related Potential Study. Neural plasticity, 2020, 8213710. https://doi.org/10.1155/2020/8213710

 

Abstract

Mindfulness interventions have been linked to improved sport performance and executive functions; however, few studies have explored the effects of mindfulness on sport performance and executive functions simultaneously. This study sought to examine whether a mindfulness training program would affect both the endurance performance and executive functions of athletes. In addition, event-related potentials (ERPs) associated with the Stroop task were assessed to investigate the potential electrophysiological activation associated with the mindfulness training. Applying a quasiexperimental design, forty-six university athletes were recruited and assigned into a five-week mindfulness training program or a waiting list control group. For each participant, the mindfulness level, endurance performance assessed by a graded exercise test, executive functions assessed via Stroop task, and N2 component of ERPs were measured prior to and following the 5-week intervention. After adjusting for the preintervention scores as a covariate, it was found that the postintervention mindfulness level, exhaustion time, and Stroop task accuracy scores, regardless of task condition, of the mindfulness group were higher than those of the control group. The mindfulness group also exhibited a smaller N2 amplitude than the control group. These results suggest that the five-week mindfulness program can enhance the mindfulness level, endurance performance, and multiple cognitive functions, including executive functions, of university athletes. Mindfulness training may also reduce conflict monitoring in neural processes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7474752/

 

Improve Executive Control in Thinking with Yoga

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Improve Executive Control in Thinking with Yoga

 

By John M. de Castro, Ph.D.

 

“yoga can be a cognitive enhancement or brain fitness exercise that can confer similar or even more extensive cognitive resilience than memory training-the gold standard-in older adults.” – Helen Lavretsky

 

Mindfulness training has been shown to be effective in improving physical and psychological health and also decreases the individual’s tendency to use tried and true solutions to problems and thereby improves cognitive flexibility. Yoga practice has been shown to have a large number of beneficial effects on the psychological, emotional, and physical health of the individual and is helpful in the treatment of mental and physical illness. Yoga practice has been shown to improve both social–emotional and cognitive skills.

 

To better understand the effects of yoga practice on young adults it is important to take into consideration that yoga is a not only a mindfulness practice, but it is also a physical exercise. It is also a complex practice that can include a number of practices including postures, meditation, breathing exercises, chanting, mantras, and relaxation. It is difficult to understand which components or combination of components are necessary and sufficient to produce improvements in cognition in young adults. Hence, it is important to investigate the differential effectiveness of different components of yoga practice.

 

In today’s Research News article “Enhancing Executive Control: Attention to Balance, Breath, and the Speed Versus Accuracy Tradeoff.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7069337/ ) Singh and Mutreja performed 2 studies to examine the postural control and breath control aspects of yoga training and their differential effects on the cognitive abilities of young adults.

 

In study 1 they recruited yoga naïve university students and had them complete measures of cognitive ability. They then were trained in yoga postures and breathing for 70 minutes twice a week for 8 weeks. 5 days after the last session they were measured again with the same measures and a new set of measures of cognitive ability. During every yoga session instructors rated the participants for postural and breath control and after the session they completed measures of positive and negative emotions.

 

They found that errors in breathing exercises were related to better short-term memory. Additionally, breath control was related to slower responding on cognitive planning tasks and faster responding on cognitive flexibility tasks. On the other hand, postural control was related to slower responding with fewer errors of perseveration.

 

In study 2 they recruited similar participants and had them complete the same measures over the same time periods as study 1 but no yoga training was conducted. The cognitive performances of these control participants were compared to the yoga trained group from study 1. They found that in comparison to baseline and the control group, after yoga training there was a significant increase in the accuracy but not the response speed on the various cognitive tasks.

 

These studies and results are interesting and suggest first that training in yoga improves cognitive performance in young healthy adults. Yoga’s ability to enhance cognition has been previously reported. Importantly, these studies also suggest that different components of yoga training, breath control and postural control are related to different speed and accuracy components of cognitive performance. This suggests that different components of yoga practice and training may have different influences on changes in cognitive abilities produced by the training.

 

These studies are important in that they begin the process of dismantling the complexities of yoga training and their relationships to the effects of yoga training. This can lead to a better understanding of how yoga practice effects cognition and to an optimization of yoga practice to improve cognitive performance. This can lead to better academic and work performance in young adults and potentially to reduced cognitive decline with aging.

 

So, improve executive control in thinking with yoga.

 

” Yoga practice may result in improved cognitive performance, among other potential benefits in healthy adults.” – Devon Brunner

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Singh, V., & Mutreja, V. (2020). Enhancing Executive Control: Attention to Balance, Breath, and the Speed Versus Accuracy Tradeoff. Frontiers in psychology, 11, 180. https://doi.org/10.3389/fpsyg.2020.00180

 

Abstract

Malleability of executive control and its enhancement through yoga training is unclear. In Study 1, participants (yoga group; n = 27, mean = 23.27 years) were tested on executive control tasks pre- and post-8 weeks of yoga training. The training focused on attention to postural control during yoga asanas and respiratory control during pranayama-breathing (30 min each of postural and breath control training, biweekly). Yoga training was assessed via performance ratings as to how well a posture was executed and by examining errors that reflected inattention/failures in postural and breath control. We also explored whether attentional demands on motor and respiratory control were associated with three components of executive control (working memory, cognitive flexibility, and inhibition) during nine executive control tasks. Partial correlation results revealed that the three components of executive control might be differentially impacted by postural and breath control and selectively associated with either speed or accuracy (except for cognitive flexibility). Attentional demands influenced the link between postural, breath, and cognitive control. In Study 2, comparisons between a yoga group and a gender-matched control group (control group; n = 27, mean = 23.33 years) pointed toward higher working memory accuracy and a better speed–accuracy tradeoff in inhibitory control in the yoga group. A ceiling-practice effect was addressed by examining yoga practice learning (i.e., practice-induced change in postural and breath control reflected in ratings and errors) on executive control performance across two sets of tasks: repeatedly tested (pre- and post-8 weeks) and non-repeatedly tested (post-8 weeks). Attention to motor and respiratory control during yoga might be considered as a potential mechanism through which specific components of executive control in young adults might be enhanced potentially via altering of speed–accuracy tradeoff.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7069337/

 

Improve Psychological Health with Mindfulness Training in Nature

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Improve Psychological Health with Mindfulness Training in Nature

 

By John M. de Castro, Ph.D.

 

“Outdoor meditation is an excellent way to improve mental health, reduce anxiety and lessen stress. The use of nature and outdoor space in meditation has been proven to yield major health benefits. Beyond just the physical impacts of lower blood pressure and other cardiovascular benefits—like what comes along with most exercise—meditation can leave you with an enhanced sense of energy and a better mood.” – EHE Health

 

Modern living is stressful, perhaps, in part because it has divorced us from the natural world that our species was immersed in throughout its evolutionary history. Modern environments may be damaging to our health and well-being simply because the species did not evolve to cope with them. This suggests that returning to nature, at least occasionally, may be beneficial. Indeed, researchers are beginning to study nature walks or what the Japanese call “Forest Bathing” and their effects on our mental and physical health.

 

Mindfulness practices have been found routinely to reduce the psychological and physiological responses to stress and improve mood. People have long reported that walking in nature elevates their mood. It appears intuitively obvious that if mindfulness training occurred in a beautiful natural place, it would greatly improve the effectiveness of mindfulness practice. Pictures in the media of meditation almost always show a practitioner meditating in a beautiful natural setting. But there is little systematic research regarding the effects of mindfulness training in nature. It’s possible that the combination might magnify the individual benefits of each.

 

In today’s Research News article “Mindfulness-Based Restoration Skills Training (ReST) in a Natural Setting Compared to Conventional Mindfulness Training: Psychological Functioning After a Five-Week Course.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7438830/) Lymeus and colleagues recruited college students with self-perceived stress and  little or no meditation experience. They were randomly assigned to receive either Conventional Mindfulness Training or Restoration Skills Training in weekly 90-minute classes over 5 weeks with daily homework assignments. A no-treatment control group was separately recruited.

 

Both trainings were modelled after the Mindfulness-Based Stress Reduction (MBSR) program with open monitoring and body scan meditation practices. The Conventional Mindfulness Training was conducted inside in a plain room while the Restoration Skills Training was conducted in a botanical garden both outside and inside in a greenhouse. It also emphasized “exploration of experiences emanating from sensory connection with stimuli in the environment.” The students were measured before and after training for mindfulness, cognitive function, and perceived stress.

 

They found that in comparison to baseline and the no-treatment control group both the Conventional Mindfulness Training and Restoration Skills Training groups had significant increases in mindfulness and cognitive functions and decreases in perceived stress with medium to large effect sizes. There were no significant differences between the 2 mindfulness training programs.

 

The present study replicates the findings that have been repeatedly demonstrated in previous research that mindfulness training increases cognitive function and decreases perceived stress. A strength of the present study was that mindfulness training in nature was compared to comparable classical mindfulness training. This allows for a direct assessment of the benefits of training in nature. Although mindfulness training in nature was found to be greatly psychologically beneficial it was not found to be superior to training inside in a plain room.

 

These results suggest that mindfulness training in nature is a viable and effective practice for the improvement of the well-being of college students. But there was no evidence that the benefits of being in nature supplemented the impact of mindfulness training. It should be noted that there may have been a ceiling effect present where both mindfulness training produced such strong benefits that there was no further room for practicing in nature to further increase the effects.

 

So, improve psychological health with mindfulness training in nature.

 

“you don’t have to choose between meditation and taking advantage of nature. Meditating outdoors is a great way to invigorate your practice and keep it going strong.” – Mindworks

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

Freddie Lymeus, Marie Ahrling, Josef Apelman, Cecilia de Mander Florin, Cecilia Nilsson, Janina Vincenti, Agnes Zetterberg, Per Lindberg, Terry Hartig. Mindfulness-Based Restoration Skills Training (ReST) in a Natural Setting Compared to Conventional Mindfulness Training: Psychological Functioning After a Five-Week Course. Front Psychol. 2020; 11: 1560. Published online 2020 Aug 12. doi: 10.3389/fpsyg.2020.01560

 

Abstract

Restoration skills training (ReST) is a mindfulness-based course that draws on restorative nature experience to facilitate the meditation practice and teach widely applicable adaptation skills. Previous studies comparing ReST to conventional mindfulness training (CMT) showed that ReST has important advantages: it supports beginning meditators in connecting with restorative environmental qualities and in meditating with less effort; it restores their attention regulation capabilities; and it helps them complete the course and establish a regular meditation habit. However, mindfulness theory indicates that effortful training may be necessary to achieve generalized improvements in psychological functioning. Therefore, this study tests whether the less effortful and more acceptable ReST approach is attended by any meaningful disadvantage compared to CMT in terms of its effects on central aspects psychological functioning. We analyze data from four rounds of development of the ReST course, in each of which we compared it to a parallel and formally matched CMT course. Randomly assigned participants (total course starters = 152) provided ratings of dispositional mindfulness, cognitive functioning, and chronic stress before and after the 5-week ReST and CMT courses. Round 4 also included a separately recruited passive control condition. ReST and CMT were attended by similar average improvements in the three outcomes, although the effects on chronic stress were inconsistent. Moderate to large improvements in the three outcomes could also be affirmed in contrasts with the passive controls. Using a reliable change index, we saw that over one third of the ReST and CMT participants enjoyed reliably improved psychological functioning. The risk of experiencing deteriorated functioning was no greater with either ReST or CMT than for passive control group participants. None of the contrasts exceeded our stringent criterion for inferiority of ReST compared with CMT. We conclude that ReST is a promising alternative for otherwise healthy people with stress or concentration problems who would be less likely to complete more effortful CMT. By adapting the meditation practices to draw on restorative setting characteristics, ReST can mitigate the demands otherwise incurred in early stages of mindfulness training without compromising the acquisition of widely applicable mindfulness skills.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7438830/

 

Improve Cognitive Flexibility with Mindful Non-Reactivity

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Improve Cognitive Flexibility with Mindful Non-Reactivity

 

By John M. de Castro, Ph.D.

 

“Mindfulness meditation practice and self-reported mindfulness were correlated directly with cognitive flexibility and attentional functioning.” – Daphne Davis

 

Mindfulness training has been shown to be effective in improving physical and psychological health and particularly with the physical and psychological reactions to stress. Mindfulness also decreases the individual’s tendency to use tried and true solutions to problems and thereby improves cognitive flexibility. This has led to an increasing adoption of these mindfulness techniques for the health and well-being of both healthy and ill individuals.

 

Mindfulness, however, is complex and includes facets such as observing, describing, non-reacting, non-judging, and acting with awareness. It is not known which of these facets or which combinations of facets are responsible for the beneficial effects of mindfulness including improved cognitive flexibility. Hence there is a need to investigate the facets of mindfulness and their relationship to the psychological flexibility of the participants.

 

In today’s Research News article “The Mediating Role of Non-reactivity to Mindfulness Training and Cognitive Flexibility: A Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2020.01053/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1365539_69_Psycho_20200630_arts_A), Zou and colleagues recruited online moderately stressed adults who did not have a mindfulness practice. They were matched and randomly assigned to a wait-list control condition or to receive a once a week for 2.5 hours for 8 weeks Mindfulness-Based Stress Reduction (MBSR) program. MBSR includes meditation, body scan, yoga practices, and discussion along with 45-minute daily home guided meditation practice. They were measured, before, twice during, and after training for mindfulness, including observing, describing, non-reacting, non-judging, and acting with awareness facets, cognitive flexibility, and perceived stress.

 

They found that in comparison to baseline and the wait-list control group, the group that received the Mindfulness-Based Stress Reduction (MBSR) program had significant increases in cognitive flexibility. A mediation analysis revealed that MBSR training solely indirectly by increasing the non-reactivity facet of mindfulness which in turn increased cognitive flexibility. Surprisingly, although perceived stress decreased over the 8-week period, there was no significant difference between groups.

 

Cognitive flexibility is ‘the ability to flexibly and adaptively respond to the environments, as opposed to the rigid or automatic thinking style, triggered by prior experience”.  Non-reactivity involves allowing experiences to come and go without reacting in an effort to change them. By not reacting in an autonomic way, it opens up the ability to react flexibly and adaptively to the situation. This ability makes the individual better able to address events in their life and thereby improve their well- being.

 

So, improve cognitive flexibility with mindful non-reactivity.

 

“mindfulness involves cultivation of a “beginner’s mind”, and demonstrate that mindfulness practice reduces cognitive rigidity via the tendency to overlook simple novel solutions to a situation due to rigid and repetitive thought patterns formed through experience.” – Jonathan Greenberg

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Zou Y, Li P, Hofmann SG and Liu X (2020) The Mediating Role of Non-reactivity to Mindfulness Training and Cognitive Flexibility: A Randomized Controlled Trial. Front. Psychol. 11:1053. doi: 10.3389/fpsyg.2020.01053

 

Mindfulness training has been shown to have a beneficial effect on cognitive flexibility. However, little is known about the mediators that produce this effect. Cross-sectional studies show that there might be a link between Non-judgment, Non-reactivity and cognitive flexibility. Longitudinal studies examining whether Non-judgment or Non-reactivity mediate the effectiveness of mindfulness training on improving cognitive flexibility are lacking. The present study aims to test the effect of mindfulness training on increasing cognitive flexibility and to test whether this effect is mediated by Non-judgment or Non-reactivity. We conducted a single-blind randomized controlled trial in 54 nonclinical high-stress participants between October 2018 and January 2019. Participants were randomly assigned to a Mindfulness Based Stress Reduction (MBSR) group or a waitlist control group. The experimenters were blind to the group assignment of participants. The MBSR group received 8-weekly sessions (2.5-h per week) and a one-day retreat (6-h), and was required to accomplish a 45-min daily formal practice during the intervention. The waitlist control group did not receive any intervention during the waiting period and received a 2-day (6-h per day) mindfulness training after the post-intervention. The primary outcome was self-report cognitive flexibility and perceived stress administered before and after MBSR. The secondary outcome was self-report mindfulness skills (including Non-reactivity and Non-judgment) measured at pre-treatment, Week 3, Week 6, and post-intervention. For cognitive flexibility, mixed-model repeated-measure ANOVA results showed that there were significant main effects of Time, Group and a significant interaction of Time by Group. Follow-up ANOVA indicated that the MBSR group was associated with greater improvements in cognitive flexibility than the waitlist. Path analysis results showed that the effect of the treatment on cognitive flexibility at post-treatment was fully mediated by Non-reactivity at Week 6. The mediation effects of Non-reactivity at Week 3, and Non-judgment at Week 3 and Week 6 were not significant. Our findings support the efficacy of MBSR on improving cognitive flexibility. Non-reactivity is an important element of the effectiveness of MBSR training on cognitive flexibility.

https://www.frontiersin.org/articles/10.3389/fpsyg.2020.01053/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1365539_69_Psycho_20200630_arts_A

 

Improve Cognitive Function in the Elderly with Tai Chi

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Improve Cognitive Function in the Elderly with Tai Chi

 

By John M. de Castro, Ph.D.

 

“tai chi appears to improve executive function—the ability to multitask, manage time, and make decisions—in people without any cognitive decline. In those with mild cognitive impairment, tai chi slowed the progression to dementia more than other types of exercise and improved their cognitive function in a comparable fashion to other types of exercise or cognitive training.” – Harvard Health

 

The aging process involves a systematic progressive decline in every system in the body, the brain included. This includes our cognitive (mental) abilities which decline with age including impairments in memory, attention, and problem-solving ability. It is inevitable and cannot be avoided. Research has found that mindfulness practices reduce the deterioration of the brain that occurs with aging restraining the loss of neural tissue. Indeed, the brains of practitioners of meditation and yoga have been found to degenerate less with aging than non-practitioners. Tai Chi and Qigong have also been shown to be beneficial in slowing or delaying physical and mental decline with aging. The research findings have been accumulating. So, it makes sense to step back and summarize what has been learned about the effectiveness of Tai Chi for reducing cognitive decline during aging.

 

In today’s Research News article “Tai Chi is Effective in Delaying Cognitive Decline in Older Adults with Mild Cognitive Impairment: Evidence from a Systematic Review and Meta-Analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7132349/), Yang and colleagues review, summarize, and perform a meta-analysis of the effects of Tai Chi practice on mental decline in the elderly. They identified 11 published research studies with a total of 1061 participants over the age of 60 with mild cognitive impairment.

 

They report that the published research found that Tai Chi practice produced a significant increase in global cognitive function including improved memory, learning ability, mental speed, attention, ideas, abstraction, creativity, mental flexibility, and visuospatial perception. In general, the effect sizes were modest, but they tended to signal a reversal of the decline. Hence, Tai Chi practice appears to improve the mental capabilities of the elderly with mild cognitive impairment. The studies included in the analysis did not have a comparison of Tai Chi practice to another form of exercise. So, it is possible that the benefits were produced, not by Tai Chi per se but by moderate exercise.

 

Tai Chi is an ancient mindfulness practice that involves slow prescribed movements. It is gentle and completely safe, can be used with the elderly and sickly, are inexpensive to administer, can be performed in groups or alone, at home or in a facility or even public park, and can be quickly learned. In addition, it can be practiced in social groups without professional supervision. This can make it fun, improving the likelihood of long-term engagement in the practice. This suggests that Tai Chi practice should be recommended for inclusion in the lifestyle of aging individuals.

 

So, improve cognitive function in the elderly with Tai Chi.

 

“Tai Chi has consistent, small effects on improving cognitive performance in both healthy older adults and older adults with some cognitive impairment.” – P. M. Wayne

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Yang, J., Zhang, L., Tang, Q., Wang, F., Li, Y., Peng, H., & Wang, S. (2020). Tai Chi is Effective in Delaying Cognitive Decline in Older Adults with Mild Cognitive Impairment: Evidence from a Systematic Review and Meta-Analysis. Evidence-based complementary and alternative medicine : eCAM, 2020, 3620534. https://doi.org/10.1155/2020/3620534

 

Abstract

To determine whether Tai Chi (TC) is effective in slowing cognitive decline in older populations with mild cognitive impairment (MCI), we performed a systematic review and meta-analysis of randomized controlled trials (RCTs) on Tai Chi and MCI. We searched eight electronic databases (PubMed, PsycINFO, Wanfang, Web of Science, MEDLINE, CNKI, EBSCO, and the Cochrane Central Register of Controlled Trials) for appropriate RCTs published up to August 2019. For those studies included, the data were extracted, methodological quality was evaluated, and then meta-analysis was performed using Review Manager software (version 5.3). A total of 11 of the studies were available for systematic review, which together included 1061 participants, met the inclusion criteria, and ten of these were included in the meta-analysis. For most RCTs, the methodological quality was moderate. The meta-analysis revealed that Tai Chi could significantly improve global cognitive function; memory and learning; mental speed and attention; ideas, abstraction, figural creations, and mental flexibility; and visuospatial perception. The present review adds to the evidence showing that Tai Chi is potentially beneficial in improving cognitive functions among elderly people with MCI. However, strictly designed and well-reported RCTs are required.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7132349/

 

Spirituality is Associated with Better Decision Making and Well-Being at End of Life

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Spirituality is Associated with Better Decision Making and Well-Being at End of Life

 

By John M. de Castro, Ph.D.

 

“spirituality is an important component of quality of life and may be a key factor in how people cope with illness, experience healing, and achieve a sense of coherence.” – Christina Puchalski

 

Death in inevitable, but that does not mean that it has to be difficult. Suzuki Roshi at the end of his life was in excruciating pain from cancer yet he told everyone around him “Don’t worry, It’s just Buddha suffering”. He passed with a smile on his face. Augustus Montague Toplady, the preacher author of the hymn “Rock of Ages” dying from tuberculosis said “Oh, what delights! Who can fathom the joy of the third heaven? The sky is clear, there is no cloud; come Lord Jesus, come quickly!” These stories exemplify how spirituality can influence the quality of life at the end of life.

 

Spirituality becomes much more important to people when they’re approaching the end of life. It is thought that people take comfort in the spiritual when facing mortality. But, spiritual concerns, such as feelings of being abandoned by god or needing forgiveness for actions in their lives might lead to anxiety and worry rather than comfort and can exacerbate the psychological burdens at the end of life. Hence, there is a need to study the relationship of spirituality to a palliative care patient’s well-being at the approach of the end of life.

 

In today’s Research News article “The influence of spirituality on decision-making in palliative care outpatients: a cross-sectional study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7035674/), Rego and colleagues recruited adult outpatients from cancer palliative care institutes who had terminal illnesses. They were asked to complete measures of decision conflict and health related quality of life including spiritual well-being and undergo a semi-structured interviews addressing “spirituality, the importance of spirituality during illness, spiritual care, the influence of illness in the sense/meaning of life and the ability to make decisions related to health.”

 

They found that patients who indicated that spirituality was important in dealing with their illness and had a sense of meaning in their lives reported significantly higher levels of spiritual well-being, quality of life, and significantly lower levels of decisional conflict. In addition, they found that higher levels of spiritual wellbeing were associated with higher levels of physical, emotional and functional wellbeing, meaning/peace and faith, and quality of life. Also, spiritual well-being was significantly associated with lower levels of uncertainty and decisional conflict and higher levels of being informed and supported, and satisfaction with decisions. Finally, the patients indicated that spiritual care was important but there was little provided.

 

It should be noted that this study was correlative and as such conclusions about causation cannot be definitively made. But the results suggest that there are clear relationships between spirituality and the ability to cope with end of life issues. Spirituality was related to many components of well-being, suggesting that while approaching end of life having deeper sense of meaning is important in dealing with mortality. In addition, spirituality appears to be associated with better capacity to make decisions, suggesting that it aids in having a clear mind in dealing with the issues associated with the remainder of their lives.

 

It is interesting that as important spirituality appears to be for dealing with the end of life the patients reported that there was very little spiritual care available. This suggests that palliative care should include greater spiritual care. The results suggest that if there was greater spiritual care it would help ease the burden of being terminally ill and improve the quality of their remaining life.

 

Hence, spirituality is associated with better decision making and well-being at end of life.

 

“Spirituality is too important and too impactful to ignore. We must work together as palliative care advocates to ensure that patients get comprehensive, person-centered care that addresses all aspects of their quality of life.” – Coalition for Compassionate Care

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Rego, F., Gonçalves, F., Moutinho, S., Castro, L., & Nunes, R. (2020). The influence of spirituality on decision-making in palliative care outpatients: a cross-sectional study. BMC palliative care, 19(1), 22. https://doi.org/10.1186/s12904-020-0525-3

 

Abstract

Background

Decision-making in palliative care can be complex due to the uncertain prognosis and general fear surrounding decisions. Decision-making in palliative care may be influenced by spiritual and cultural beliefs or values. Determinants of the decision-making process are not completely understood, and spirituality is essential for coping with illness. Thus, this study aims to explore the influence of spirituality on the perception of healthcare decision-making in palliative care outpatients.

Methods

A cross-sectional study was developed. A battery of tests was administered to 95 palliative outpatients, namely: sociodemographic questionnaire (SQ), Decisional Conflict Scale (DCS), Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being scale (FACIT-Sp), and a semi-structured interview (SSI) to study one’s perception of spirituality and autonomy in decision-making. Statistical analyses involved descriptive statistics for SQ and SSI. The Mann-Whitney test was used to compare scale scores between groups and correlations were used for all scales and subscales. The analysis of patients’ definitions of spirituality was based on the interpretative phenomenological process.

Results

Spiritual wellbeing significantly correlated with greater levels of physical, emotional and functional wellbeing and a better quality of life. Greater spiritual wellbeing was associated with less decisional conflict, decreased uncertainty, a feeling of being more informed and supported and greater satisfaction with one’s decision. Most patients successfully implemented their decision and identified themselves as capable of early decision-making. Patients who were able to implement their decision presented lower decisional conflict and higher levels of spiritual wellbeing and quality of life. Within the 16 themes identified, spirituality was mostly described through family. Patients who had received spiritual care displayed better scores of spiritual wellbeing, quality of life and exhibited less decisional conflict. Patients considered spirituality during illness important and believed that the need to receive spiritual support and specialised care could enable decision-making when taking into consideration ones’ values and beliefs.

Conclusion

The impact of spiritual wellbeing on decision-making is evident. Spirituality is a key component of overall wellbeing and it assumes multidimensional and unique functions. Individualised care that promotes engagement in decision-making and considers patients’ spiritual needs is essential for promoting patient empowerment, autonomy and dignity.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7035674/