Efficacy of Meditation in the Management of Anxiety Disorders

Danny Burr, RN, BSNUniversity of Central Florida

College of NursingNGR 6813

Anxiety Disorders

• Anxiety disorders are the most common mental illness in the U.S.

• affecting 40 million adults in the United States age 18 and older (18.1% of U.S. population)

Statistics. (2008, September 2). Retrieved September 23, 2008, from National Institute of Mental Health. Statistics and Facts About Anxiety Disorders. (2008).

Anxiety Disorders

• Generalized Anxiety Disorder (GAD)• Obsessive-Compulsive Disorder (OCD)• Panic Disorder• Posttraumatic Stress Disorder (PTSD)• Social Anxiety Disorder (SAD)• Specific Phobias

What Are the Symptoms of an Anxiety Disorder?

• Feelings of panic, fear and uneasiness• Uncontrollable, obsessive thoughts• Repeated thoughts or flashbacks of

traumatic experiences• Nightmares• Ritualistic behaviors, such as repeated hand

washing• Problems sleeping• Cold or sweaty hands and/or feet• Shortness of breath

Symptoms continue

• Palpitations• An inability to be still and calm• Dry mouth• Numbness or tingling in the hands or feet• Nausea• Muscle tension• Dizziness

PROBLEM

• Influence the health and relationships of family and friends

• Diminish ability to cope with coworkers, consequently, decreased productivity

• Anxiety disorders cost the U.S. more than $42 billion a year

• More than $22.84 billion of those costs are associated with the repeated use of health care services

Purpose & Question

• investigate the effectiveness of meditation in dealing with lowering of anxiety level of those whom suffered from anxiety

• can meditations effectively facilitate anxiety reduction, maintain physiological relaxation, and improved psychological outcomes on a consistent basis?

Relevance to Nursing

• Promote holistic health• Health promotion and disease prevention• Encourage non-pharmacologic therapy• sustain the quality of their disease

management

Databases and Search Terms

• CINAHL, MEDLINE, PsycInfo, Cochrane database of systematic reviews, and Cochrane central register of controlled trials

• Keywords included meditation, relaxation, mindfulness, treatment, adjunct, alternative therapy, anxiety disorders, generalized anxiety disorder, performance anxiety, and panic disorder

Inclusion & exclusion criteria

• Published between 1995 and 2008• Available in English• Come from peer review journals• Qualitative and Quantitative designs• Adult diagnosed with anxiety disorders• Studies with children were excluded• Studies of meditation that were not well

organized program or were not aimed to treat anxiety disorders sufferer were also excluded.

Coding

• Self-awareness and self-acceptancerecognized triggersfocus on the present moment

• Reducing severity and frequency of attackutilize meditation dailymany forms, can use in most settingsreduce endocrine stimulation

Coding (cont.)

• Improve quality of lifestop avoid going to places, social activities, and communicating with their spousesincreased ability to relaxdecreased inclination to assume negative conclusionsregain healthy relationship with family and friend

Validity of finding

• Problem and purpose are clearly stated• Research question is clearly defined• Methods clearly stated and appropriate• Outcomes measure relevance to efficacy of

meditation practice• Evidence provided was reliable and valid• Limitation of the studies are addressed

Validity of finding Rating System for the Hierarchy of Evidence* • Level I Evidence for a systematic review or

meta-analysis of all relevant RCTs or evidence-based clinical practice guidelines based on systematic reviews of RCTs.

• Level II Evidence obtained from at least one well-designed RCT.

• Level III Evidence obtained from one well-designed controlled trials without randomization.

Validity of finding• Level IV Evidence from well-designed case-

control and cohort studies. • Level V Evidence from systematic reviews of

descriptive or qualitative study. • Level VI Evidence from a single descriptive or

qualities study.• Level VII Evidence from the opinion of

authorities and/or reports of expert committees. Adapted from Melnyk, B. M., & Fineout - Overholt (2005).

Evidence based practice in nursing & healthcare. Philadelphia: Lippincott Willams.

Study Characteristics

• reviewed 11 research studies• 2 articles were systematic review or meta-

analysis • 5 articles were well-designed RCT. • 3 articles were well-designed controlled trials

without randomization. • 1 article was well-designed case-control and

cohort studies. • 1 article was systematic reviews of descriptive or

qualitative study.

Study limitations

• Small sample size• 10 out of 11 studies were not follow up• 5 out of 11 studies did not have control group

to compare the data• Some subjects were on pharmacotherapy

along with meditation training

Recommendations for Nursing

• Familiarize with s/s of anxiety disorders, 60% of patients seeking primary care are experiencing anxiety disorders

• Encourage to introduce mind/body health therapy to clients

• Cost efficient for clients• Clients potentially gain sustain benefits long term• Cultural beliefs/stigma/preferred non-

pharmacologic treatment

Conclusion

• Mindfulness meditation had established to be an effective prevention for an acute episode of anxiety and panic attack.

• Its benefits for long term management proved to be sufficient method in maintaining healthy understanding of self

• Enhance relations with friend and family

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Mental Health Web Site: http://www.nimh.nih.gov/health/publications/anxiety-disorders/introduction.shtml• (Anxiety disorders 14)Anxiety Disorders. (14). Retrieved October 14, 2008, from American Psychiatric Association Web Site:

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