Efeitos da prática do Reiki sobre a qualidade de vida de gestantes diabéticas: ensaio clínico randomizado
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Data
2021-08-27
Autores
Ferraz, Guilherme Augusto Rago
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Universidade Estadual Paulista (Unesp)
Resumo
Introdução: Reiki, um tratamento não medicamentoso usado em pessoas que sofrem de ansiedade, depressão ou ambos, parece ser uma abordagem intrigante para tratar o impacto psicológico da resposta de uma mulher a um diagnóstico de hiperglicemia na gravidez com comprometimento fetal. No entanto, são necessários ensaios clínicos randomizados comparando várias técnicas de aplicação de Reiki. Objetivos: O objetivo deste ensaio é analisar se a modalidade terapêutica de imposição das mãos (Reiki) aplicada por um terapeuta habilitado em Reiki, por meio presencial ou a distância, pode ser eficaz em gestantes com hiperglicemia. Métodos: Um ensaio clínico randomizado, com 134 gestantes que apresentaram hiperglicemia por DM pré-gravidez tipo 2, glicemia em jejum ≥ 92 mg/dl no primeiro trimestre ou 75g-OGTT entre 24-28 semanas de gestação foi conduzido no Centro de Pesquisas do Diabetes Perinatal, Hospital Universitário, Faculdade de Medicina de Botucatu, UNESP, Brasil. As participantes foram randomizadas e alocadas em 3 grupos: Reiki presencial (47), Reiki a distância (43) ou Placebo (47). As análises consistiram nos resultados primários das mudanças de respostas obtidas por meio do questionário de qualidade de vida da Organização Mundial de Saúde, inventário de depressão de Beck e de ansiedade-traço após 7 sessões completas, todos os questionários aplicados são validados na língua portuguesa. Os dados obtidos foram submetidos à análise estatística por meio dos testes ANOVA, WALD, Tukey e Qui-quadrado. O ensaio foi registrado com o Número Internacional de Ensaios Clínicos Randomizados (ISRCTN), isrctn.com ISRCTN69018802; https://doi.org/10.1186/ISRCTN69018802. Resultados: Não houve diferenças significativas entre os grupos controle e intervenção nas características basais. A terapia de Reiki presencial e a distância promoveu o mesmo efeito na qualidade de vida das participantes. Considerando a qualidade de vida, no Reiki presencial, os aspectos físicos aumentaram significativamente de 58,86 para 82 (p = 0,0012), os aspectos psicológicos aumentaram de 69,5 para 84,75 (p <0,0001), os sociais melhoraram de 70,83 para 87,17 (p <0,0001) e os ambientais de 67,69 para 83,75 (p <0,0001). Da mesma forma, o inventário de depressão de Beck (BDI) foi significativamente afetado pelo Reiki presencial, uma vez que diminuiu de 10,06 para 6,72 (p = 0,0208), assim como os inventários de ansiedade traço-estado, que caíram de 41,64 para 34 (p< 0,0001) e 42,5 a 33,66 (p <0,0001), respectivamente. Além disso, o grupo do Reiki a distância apresentou resultados semelhantes ao do presencial, enquanto o Placebo não apresentou diferença entre os dados basais e após a simulação da técnica do Reiki. Além disso, os três grupos nos proporcionaram um alto nível de consistência, de acordo com as características da linha de base. Conclusão: Reiki melhorou todos os aspectos relacionados à qualidade de vida, bem como diminuiu a depressão e a ansiedade das gestantes diabéticas.
Background: Reiki, a non-drug treatment used on people suffering from anxiety, depression, or both, appears to be an intriguing approach to treating the psychological impact of a woman's response to a diagnosis of hyperglycaemia in pregnancy (HIP) with foetal compromise. However, randomized controlled trials comparing various Reiki strategies are required. Objectives: The purpose of this trial is to analyse if the therapeutic modality of laying on of hands (Reiki) delivered by a trained Reiki practitioner, either face-to-face or remotely, was more effective than Sham-Reiki in controlling the burden of HIP diagnosis among women. Methods: A randomized controlled experiment comprising 134 women with HIP diagnosed by pre-pregnancy Type 2 DM, fasting glycemia≥ 92 mg/dl in first trimester or 75g-OGTT between 24-28 gestational weeks was conducted at the Perinatal Diabetes Research Centre, University Hospital, Botucatu Medical School, UNESP, Brazil. The participants were randomized to Face-to-Face Reiki (47), Remote Reiki (43) or Sham-Reiki (47). Changes in World Health Organization Quality of Life questionnaire, Beck depression inventory and Beck State-Trait anxiety surveys were the primary outcomes after 7 full Reiki sessions by applying standardized and validated surveys in Portuguese. The obtained data were subjected to statistical analysis using ANOVA, WALD, Tukey´s and chi-square tests. The trial was registered with International Standard Randomised Controlled Trial Number (ISRCTN), isrctn.com ISRCTN69018802; https://doi.org/10.1186/ISRCTN69018802. Results: There were no significant differences between control and intervention groups in baseline characteristics. Face-to-face and Remote Reiki therapy had same effect on participants' quality of life. For Face-to-Face Reiki, the physical aspects significantly increased from 58.86 to 82 (p=0.0012), psychological aspects rose from 69.5 to 84.75 (p<0.0001), social elements improved from 70.83 to 87.17 (p<0.0001) and environmental factors enhanced from 67.69 to 83.75 (p<0.0001). Similarly, Beck's depression inventory (BDI) was significantly affected by Face-to-Face Reiki; although, it declined from 10.06 to 6.72 (p=0.0208), as did the state-trait anxiety inventories, which dropped from 41.64 to 34 (p<0.0001) and 42.5 to 33.66 (p<0.0001), respectively. Moreover, the outcomes related to Remote Reiki presented similar results as the Face-to-Face, while Sham Reiki did not present any significant difference between baseline and after Reiki application. Besides that, the three groups provided us with a high level of consistency, according to baseline traits. Conclusion: Reiki improved all aspects of the World Health Organization Quality-of-Life questionnaire, as well as lowered depression and anxiety in Beck's inventories in HIP women.
Background: Reiki, a non-drug treatment used on people suffering from anxiety, depression, or both, appears to be an intriguing approach to treating the psychological impact of a woman's response to a diagnosis of hyperglycaemia in pregnancy (HIP) with foetal compromise. However, randomized controlled trials comparing various Reiki strategies are required. Objectives: The purpose of this trial is to analyse if the therapeutic modality of laying on of hands (Reiki) delivered by a trained Reiki practitioner, either face-to-face or remotely, was more effective than Sham-Reiki in controlling the burden of HIP diagnosis among women. Methods: A randomized controlled experiment comprising 134 women with HIP diagnosed by pre-pregnancy Type 2 DM, fasting glycemia≥ 92 mg/dl in first trimester or 75g-OGTT between 24-28 gestational weeks was conducted at the Perinatal Diabetes Research Centre, University Hospital, Botucatu Medical School, UNESP, Brazil. The participants were randomized to Face-to-Face Reiki (47), Remote Reiki (43) or Sham-Reiki (47). Changes in World Health Organization Quality of Life questionnaire, Beck depression inventory and Beck State-Trait anxiety surveys were the primary outcomes after 7 full Reiki sessions by applying standardized and validated surveys in Portuguese. The obtained data were subjected to statistical analysis using ANOVA, WALD, Tukey´s and chi-square tests. The trial was registered with International Standard Randomised Controlled Trial Number (ISRCTN), isrctn.com ISRCTN69018802; https://doi.org/10.1186/ISRCTN69018802. Results: There were no significant differences between control and intervention groups in baseline characteristics. Face-to-face and Remote Reiki therapy had same effect on participants' quality of life. For Face-to-Face Reiki, the physical aspects significantly increased from 58.86 to 82 (p=0.0012), psychological aspects rose from 69.5 to 84.75 (p<0.0001), social elements improved from 70.83 to 87.17 (p<0.0001) and environmental factors enhanced from 67.69 to 83.75 (p<0.0001). Similarly, Beck's depression inventory (BDI) was significantly affected by Face-to-Face Reiki; although, it declined from 10.06 to 6.72 (p=0.0208), as did the state-trait anxiety inventories, which dropped from 41.64 to 34 (p<0.0001) and 42.5 to 33.66 (p<0.0001), respectively. Moreover, the outcomes related to Remote Reiki presented similar results as the Face-to-Face, while Sham Reiki did not present any significant difference between baseline and after Reiki application. Besides that, the three groups provided us with a high level of consistency, according to baseline traits. Conclusion: Reiki improved all aspects of the World Health Organization Quality-of-Life questionnaire, as well as lowered depression and anxiety in Beck's inventories in HIP women.
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Palavras-chave
Toque terapêutico, Gravidez, Diabetes mellitus gestacional, Práticas de saúde complementares e integrativas, Pré-natal, Reiki, Therapeutic touch, Pregnancy, Gestational diabetes mellitus, Complementary alternative medicine, Antenatal care,