Exploring the Health Benefits of Using Relaxation Therapies with Children

Transcription

1 Exploring the Health Benefits of Using Relaxation Therapies with Children Wendy Sewell Children s Diabetes Nurse Specialist /Team Leader gwendoline.sewell@leedsth.nhs.uk

2 Overview Physiology of Stress Stress and Health Psychological Theories Study Findings Main themes Relaxation interventions Conclusion

3 Physiology of Stress Heart rate Breathing Release of adrenalin Blood pressure Tightening of muscles Redirection of Blood flow Heightened senses Perspiration Sympathetic Nervous System Stressed out

4 Stress and Health Influences the immune response Affects and exacerbates chronic conditions such as asthma & diabetes Anxiety & depressive illness Fear of pain and procedures Cause & Effects Stressed zebra

5 Psychological Theories Social Learning Theory Considers how people learn through their experiences and interaction with others. Example: A child may learn fear of going to the dentist from a parent

6 Psychological theories ctd. Theory of Planned Behaviour Considers ones attitudes to carry out behaviour dependent on the attitudes towards that behaviour, subjective norms and perceived behavioural control. Example: Those who believe they would like the taste of healthy food are more likely to choose and eat them

7 Psychological theories ctd. Health Belief Model Suggest that if there is a perceived benefit of the intervention then the more likely a person will undertake that intervention. Example: If an individual believes that a relaxation intervention will be helpful, the more likely it is to occur

8 Methodology Formulate question Search strategy Study selection Quality assessment Data extraction Data synthesis & analysis CYP up to 18 years Intervention used for positive benefit in chronic disease management 1990 to 2008 Experimental, quasi experimental and descriptive studies Systematic Review Inclusion Criteria

9 Research Question What health benefits are gained from using relaxation therapies with children and young people?

10 Studies 4 RCT s 3 case studies 5 Pre and post design 2 observational studies Asthma Headaches & migraine Recurrent abdominal pain Diabetes Needle phobia Self regulation of HR & BP 15 studies included Used for

11 Analysis Thematic analysis Method for identifying, analyzing and reporting patterns within data which can provide a rich detailed and complex amount of data (Braun & Clarke, 2006)

12 Findings 9 studies used hypnosis or self hypnosis 5 used relaxation or guided imagery 2 used relaxation and thermal bio feedback All showed improvement in symptoms Medication School attendance & other activities Vlieger et al (2007) gut directed hypnotherapy is highly effective for treating children with recurrent abdominal pain

13 Themes Transferable tool and life skill teaching, mastery and practice Beneficial and positive (especially beneficial when used for recurrent abdominal pain) Children and young people in control Rapport building rapport, positive and nurturing relationships, warmth and empathy

14 Relaxation Interventions General muscle relaxation Hypnosis Guided Imagery Interactive guided imagery Meditation Relaxation of body Use of the mind Imagination Use of major senses Focused attention Attention and distraction Facets

15 General Muscle Relaxation The systematic relaxation of groups of muscles in the body. Can work from head to toe or toe to head.

16 Relaxation Interventions Hypnosis Hypnosis denotes the interaction between one person and another to influence the subject s perceptions, feelings, thinking and behaviour by asking them to concentrate on ideas and images that may evoke the intended effect ( The British Psychological Society 2001, p3)

17 Guided Imagery Powerful in reducing pain and distress by distraction. The more innovative the distraction, the more powerful the effect as it requires more attention. Examples: Stories Toys Bubbles

18 Interactive Guided Imagery Requires trust and rapport to engage with the child. Interactive stories which allows the health care professional to guide the child through a situation. Example: Star wars story for venepuncture

19 Conclusions Relaxation therapies aid by... Building on positive strengths Increasing self awareness Promoting high internal locus of control As a result... Anxiety and stress levels Stress response Gain a positive coping strategy More motivated to adhere to prescribed treatment regimens More likely to engage in healthy behaviours

20 Implications for Practice Communication Building rapport Counselling techniques Awareness of the mind/body connection Learning simple distraction techniques Consider relaxation techniques Training on relaxation techniques Further empirical research

21 The mind is its own place and in itself, can make a Heaven of Hell, a Hell of Heaven John Milton, Paradise Lost