Angela Dossett is clinical practice leader, Anne Smith is nursing practice leader, Marcia K. Gingerich is nurse manager, and Laura Cullen is evidence-based practice scientist, all at the University of Iowa Hospitals and Clinics, Iowa City. Contact author: Angela Dossett,
Am J Nurs. 2022 Jul 1;122(7):28-36. doi: 10.1097/01.NAJ.0000840304.76501.96.
Yoga-based treatments, which are recognized by the National Institutes of Health's National Center for Complementary and Integrative Health as a form of complementary and alternative medicine, have proven to be beneficial for people with various psychiatric disorders, including depression, anxiety, posttraumatic stress disorder, and attention deficit-hyperactivity disorder, as well as schizophrenia and other psychotic disorders.
The purpose of this evidence-based practice (EBP) project was to offer structured yoga sessions as a means of providing stress relief, promoting relaxation, reducing anxiety, and improving quality of care among male and female adult patients (ages 18 years and older) hospitalized in a locked medical-psychiatric unit within an academic medical center for treatment of both acute medical and acute psychiatric conditions.
The Iowa Model and Implementation Strategies for EBP provided the guiding framework for this pilot project. Patients were offered once weekly, 30-to-60-minute yoga sessions for 12 weeks and were screened for their ability to participate by the nurse-yoga instructor and the interprofessional team. Using a Precision Implementation Approach, a data-driven selection of strategies from the implementation framework promoted the adoption and sustainability of the practice change, which were further advanced through interprofessional reinforcement of yoga practice and internal reporting.
Patient feedback was sought before and after yoga sessions. Thirty-nine patients responded to the pre-yoga questionnaire and 38 patients responded to the post-yoga questionnaire. Patients reported improved mood after yoga, with 23% (nine of 39) reporting feelings of calm and relaxation pre-yoga compared with 76% (29 of 38) post-yoga, and 41% (16 of 39) reporting feelings of anxiety pre-yoga compared with just 5% (two of 38) post-yoga.
Yoga sessions provided by a nurse certified in yoga instruction improved patients' mood and sense of well-being. Instructional materials and videos were created to promote sustained use. The EBP of providing yoga sessions grew from a pilot program to a sustained change with more widespread use. In addition to patients hospitalized on medical-psychiatric units, the health system expanded the sessions to include inpatients on behavioral health units.
瑜伽疗法已被美国国立卫生研究院国家补充与综合健康中心认可为补充和替代医学的一种形式,事实证明,其对各种精神疾病患者(包括抑郁症、焦虑症、创伤后应激障碍和注意缺陷多动障碍以及精神分裂症和其他精神病障碍)有益。
本循证实践(EBP)项目旨在提供结构化的瑜伽课程,为在学术医疗中心的锁定医疗-精神病病房住院的男性和女性成年患者(18 岁及以上)提供缓解压力、促进放松、减轻焦虑和提高护理质量的方法,这些患者患有急性医疗和急性精神疾病。
爱荷华模式和 EBP 实施策略为该试点项目提供了指导框架。每周一次,每次 30 至 60 分钟,共 12 周,由护士-瑜伽指导员和跨专业团队对患者进行参与能力筛查。使用精确实施方法,从实施框架中选择策略,促进了实践变革的采用和可持续性,通过跨专业强化瑜伽练习和内部报告进一步推进了变革。
在瑜伽课程前后,向患者征求了反馈意见。39 名患者在瑜伽课前回答了问卷,38 名患者在瑜伽课后回答了问卷。患者报告瑜伽后情绪改善,课前有 23%(39 人中的 9 人)感到平静和放松,课后有 76%(38 人中的 29 人);课前有 41%(39 人中的 16 人)感到焦虑,课后只有 5%(38 人中的 2 人)感到焦虑。
由经过瑜伽指导认证的护士提供的瑜伽课程改善了患者的情绪和幸福感。制作了教学材料和视频,以促进持续使用。提供瑜伽课程的 EBP 从试点项目发展为更广泛使用的持续变革。除了在医疗-精神病病房住院的患者外,该医疗系统还将课程扩大到包括行为健康病房的住院患者。