Efetividade da terapia floral na ansiedade de adultos com sobrepeso ou obesidade: ensaio clínico randomizado e controlado
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2018-02-28
Autores
Fusco, Suzimar de Fátima Benato
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Universidade Estadual Paulista (Unesp)
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Introdução: A prevalência da obesidade vem aumentando entre adultos em todo o mundo e está associada com aumento do risco de morbimortalidade, bem como redução da expectativa de vida com resultados negativos de saúde. Também associa-se a outras patologias como transtorno de ansiedade, comportamento compulsivo e desequilíbrio no comportamento do sono. Apesar da obesidade ser considerada uma patologia previnível, ainda existem grandes dificuldades associadas com a perda de peso e a sua manutenção através da modificação do estilo de vida no cenário atual, mostrando a necessidade de investigação de fatores que abordem não só o peso, mas também patologias e/ou sintomas associados. A terapia floral faz parte de um campo emergente de terapias vibracionais, e suas essências, feitas a partir de plantas silvestres, flores e árvores do campo, atuam harmonizando as emoções, e não tratando de condições físicas. Neste contexto, aparece como uma alternativa para o alivio do comportamento ansioso dos indivíduos, pois não há incompatibilidade com outros métodos de tratamento, e pode ser indicada a um grande número de pessoas em qualquer etapa da vida. Objetivo: Identificar se o tratamento com terapia floral altera o grau de ansiedade de indivíduos com sobrepeso ou obesidade, com consequente melhora no padrão de sono, redução nos sintomas de compulsão alimentar, redução na frequência cardíaca de repouso e melhora nos níveis de pressão arterial. Métodos: Ensaio Clínico Randomizado, paralelo, com dois braços, duplo cego, placebo-controlado, de quatro semanas, realizado em uma instituição pública do estado de São Paulo - Brasil. Os participantes foram indivíduos sadios de ambos os sexos, com idade de 20 a 59 anos, alfabetizados, com sobrepeso ou obesidade pelos critérios da Organização Mundial da Saúde (IMC ≥ 25 Kg/m2) e com ansiedade moderada ou elevada pelos critérios do Inventário de Ansiedade-Estado (IDATE com Escore ˃ 34). Para a coleta de dados utilizou-se questionário sócio-demográfico e clínico, escala de ansiedade IDATE-ESTADO, Escala de Compulsão Alimentar Periódica (ECAP) e Questionário de Padrão do Sono de Pittsburg (PSQI), aferição da pressão arterial e eletrocardiograma, no momento inicial e após 4 semanas de tratamento. A análise estatística foi realizada calculando o delta para expressar a diferença das médias das medidas de desfecho entre os momentos de avaliação dentro de cada grupo estudado. Em seguida, utilizou-se o Teste de Mann-Whittney para a comparação entre grupos. Análise multivariada foi realizada utilizando modelos de regressão linear robusta simples e múltipla. Resultados: A coleta de dados ocorreu entre setembro de 2015 e janeiro de 2017 e a amostra foi constituída por 40 participantes no grupo placebo e 41 no grupo floral, principalmente pelo sexo feminino (92,5% e 90,2%), com idade média de 42,9 e 38,5 anos e IMC médio de 34,31 e 33,5 kg/m2 nos grupos placebo e floral respectivamente. A análise multivariada mostrou redução estatisticamente significante no grupo floral quando comparado ao grupo Placebo nas seguintes variáveis: IDATE (β=-0,190; p<0,001), PSQI (β=-0,160; p=0,027), ECAP (β=-0,226; p=0,001) e frequência cardíaca de repouso (β=-0,07; p=0,003). Conclusão: indivíduos tratados com terapia floral apresentaram redução de sintomas ansiosos, melhora no padrão de sono, redução nos sintomas de compulsão alimentar e diminuição na frequência cardíaca de repouso maior do que aqueles tratados com placebo. Esse resultado evidencia a importância e a necessidade de ações de saúde em prol da redução da ansiedade e sintomas associados em indivíduos com sobrepeso ou obesidade e fortalece a terapia floral como prática integrativa e complementar na área da saúde.
Introduction: The prevalence of obesity is increasing among adults worldwide and is associated with an increased risk of morbidity and mortality, as well as a reduction in life expectancy with negative health outcomes. It is also associated with other pathologies such as anxiety disorder, compulsive behavior and imbalance in sleep behavior. Although obesity is considered a predictable pathology, there are still great difficulties associated with weight loss and its maintenance by modifying lifestyle in the current scenario, showing the need to investigate factors that address not only weight but also pathologies and / or associated symptoms. Floral therapy is part of an emerging field of vibrational therapies, and its essences, made from wild plants, flowers and field trees, work by harmonizing emotions, not by treating physical conditions. In this context, it appears as an alternative for the relief of the anxious behavior of individuals, as there is no incompatibility with other treatment methods, and can be indicated to a large number of people at any stage of life. Objective: To identify whether treatment with floral therapy changes the degree of anxiety of overweight or obese individuals, with consequent improvement in sleep pattern, reduction in binge eating symptoms, reduction in resting heart rate and improvement in blood pressure levels. Methods: Randomized, parallel, two-arm, double-blind, placebo-controlled, four-week clinical trial conducted at a public stitution in the state of São Paulo - Brazil. Participants were healthy individuals of both sexes, aged 20-59 years, literate, overweight or obese according to World Health Organization criteria (BMI ≥ 25 kg / m2) and with moderate or high anxiety according to the criteria of the State - Trait Anxiety Inventory (STAI) (STAI with Score ˃ 34). Data were collected using a sociodemographic and clinical questionnaire, State - Trait Anxiety Inventory (STAI), Binge-Eating Scale (BES) and Pittsburgh Sleep Quality Index (PSQI), blood pressure and electrocardiogram and after 4 weeks of treatment. Statistical analysis was performed by calculating the delta to express the difference of means of outcome measures between the moments of evaluation within each group studied. Then, the Mann-Whittney test was used for the comparison between groups. Multivariate analysis was performed using simple and multiple robust linear regression models. Results: Data collection occurred between September 2015 and January 2017, and the sample consisted of 40 participants in the placebo group and 41 in the floral group, mainly female (92.5% and 90.2%), with age mean of 42.9 and 38.5 years and mean BMI of 34.31 and 33.5 kg / m2 in the placebo and floral groups, respectively. The multivariate analysis showed a statistically significant reduction in the floral group when compared to the placebo group in the following variables: IDATE (β = -0.190, p <0.001), PSQI (β = -0.160, p = 0.004), ECAP (β = -0.226; p = 0.001) and resting heart rate (β = -0.07, p <0.001). Conclusion: Individuals treated with floral therapy had reduced anxiety symptoms, improved sleep patterns, reduced binge eating symptoms, and decreased resting heart rate greater than those treated with placebo. This result evidences the importance and necessity of health actions in favor of the reduction of anxiety and associated symptoms in overweight or obese individuals and strengthens floral therapy as an integrative and complementary practice in the health area.
Introduction: The prevalence of obesity is increasing among adults worldwide and is associated with an increased risk of morbidity and mortality, as well as a reduction in life expectancy with negative health outcomes. It is also associated with other pathologies such as anxiety disorder, compulsive behavior and imbalance in sleep behavior. Although obesity is considered a predictable pathology, there are still great difficulties associated with weight loss and its maintenance by modifying lifestyle in the current scenario, showing the need to investigate factors that address not only weight but also pathologies and / or associated symptoms. Floral therapy is part of an emerging field of vibrational therapies, and its essences, made from wild plants, flowers and field trees, work by harmonizing emotions, not by treating physical conditions. In this context, it appears as an alternative for the relief of the anxious behavior of individuals, as there is no incompatibility with other treatment methods, and can be indicated to a large number of people at any stage of life. Objective: To identify whether treatment with floral therapy changes the degree of anxiety of overweight or obese individuals, with consequent improvement in sleep pattern, reduction in binge eating symptoms, reduction in resting heart rate and improvement in blood pressure levels. Methods: Randomized, parallel, two-arm, double-blind, placebo-controlled, four-week clinical trial conducted at a public stitution in the state of São Paulo - Brazil. Participants were healthy individuals of both sexes, aged 20-59 years, literate, overweight or obese according to World Health Organization criteria (BMI ≥ 25 kg / m2) and with moderate or high anxiety according to the criteria of the State - Trait Anxiety Inventory (STAI) (STAI with Score ˃ 34). Data were collected using a sociodemographic and clinical questionnaire, State - Trait Anxiety Inventory (STAI), Binge-Eating Scale (BES) and Pittsburgh Sleep Quality Index (PSQI), blood pressure and electrocardiogram and after 4 weeks of treatment. Statistical analysis was performed by calculating the delta to express the difference of means of outcome measures between the moments of evaluation within each group studied. Then, the Mann-Whittney test was used for the comparison between groups. Multivariate analysis was performed using simple and multiple robust linear regression models. Results: Data collection occurred between September 2015 and January 2017, and the sample consisted of 40 participants in the placebo group and 41 in the floral group, mainly female (92.5% and 90.2%), with age mean of 42.9 and 38.5 years and mean BMI of 34.31 and 33.5 kg / m2 in the placebo and floral groups, respectively. The multivariate analysis showed a statistically significant reduction in the floral group when compared to the placebo group in the following variables: IDATE (β = -0.190, p <0.001), PSQI (β = -0.160, p = 0.004), ECAP (β = -0.226; p = 0.001) and resting heart rate (β = -0.07, p <0.001). Conclusion: Individuals treated with floral therapy had reduced anxiety symptoms, improved sleep patterns, reduced binge eating symptoms, and decreased resting heart rate greater than those treated with placebo. This result evidences the importance and necessity of health actions in favor of the reduction of anxiety and associated symptoms in overweight or obese individuals and strengthens floral therapy as an integrative and complementary practice in the health area.
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Palavras-chave
Essências florais, Obesidade, Ansiedade, Sleep initiation and maintenance disorder, Obesity anxiety, Flower essences, Transtorno da compulsão alimentar, Distúrbios do início e da manutenção do sono, Binge-eating disorder