Chen, K.W., Berger, C.C., Manheimer, E., Forde, D., Magidson, J., Dachman, L., & Lejuez, C.W. (2012). Meditative therapies for reducing anxiety: A systematic review and meta‐analysis of randomized controlled trials. Depression and Anxiety, 29, 545–562.

DOI Link

Purpose

STUDY PURPOSE: To investigate all types of meditative therapies for overall efficacy and effect size for reducing anxiety in various types of patients
TYPE OF STUDY: Meta-analysis and systematic review
 

Search Strategy

DATABASES USED: PubMed, EMBASE, PsycInfo, Cochrane collaboration Qigong database
KEYWORDS: Keywords incorporated various types of practices including yoga, reiki, guided imagery, and mindfulness.
INCLUSION CRITERIA: RCT, anxiety was an outcome with a psychometric measure, sample size of more than 20, anxiety level data provided for baseline and postintervention
EXCLUSION CRITERIA: Qualitative report, literature review, combined measure of anxiety and stress, no psychometric measure of anxiety alone

Literature Evaluated

TOTAL REFERENCES RETRIEVED: 1,030 references were retrieved.

EVALUATION METHOD AND COMMENTS ON LITERATURE USED: Use the CLEAR = NPT quality checklist. Most studies did not provide the information needed for quality assessment. Sixteen studies had good quality, and 17 had moderate or acceptable quality.

Sample Characteristics

  • FINAL NUMBER STUDIES INCLUDED = 40; 36 in meta analysis
  • SAMPLE RANGE ACROSS STUDIES: 18–207
  • KEY SAMPLE CHARACTERISTICS: Only 3 studies included were done with patients with cancer. Several studies were done with healthy subjects and college students.

Phase of Care and Clinical Applications

PHASE OF CARE: Not provided

Results

In meta-analysis, overall results in comparison to wait list controls to interventions had standard mean difference (SMD) of –0.52 (95% confidence interval [CI] [–0.79, –0.41]). Results in comparison to attention control condition had SMD of –0.59 (95% CI -[–0.79, –0.39]). Results in comparison to an alternative intervention had SMD of –0.27 (95% CI [–0.46, –0.09]). Studies conducted in China and Japan had larger effect sizes, and lower quality studies had larger effect sizes.

Conclusions

Interventions incorporating meditative practices have overall positive effects on mood.

Limitations

Very few studies included patients with cancer, and the review incorporated findings from normal health controls as well as individuals with various acute and chronic diseases. All types of practices including imagery and those involving movement were considered together. Although there are certainly some similarities in the mental components of many of these practices, it is unclear that they would be routinely viewed as the same. Many studies also included counseling, education, and psychoeducational types of components, which can be expected to confound results.

Nursing Implications

Findings suggest that in the general population and patients with various types of chronic disease, interventions that involve incorporation of mindfulness and meditative types of practice may be beneficial in reducing anxiety. The application specifically forcancer care is difficult to determine because there were so few studies involving patients with cancer. Nurses can expect that some patients may benefit from meditative practices, and these approaches may be more acceptable to some ethnic groups.

Legacy ID

4001