Meditation and its Effects on Anxiety

Project Description 

Medically anxiety is a disorder that is often referred to as Generalized Anxiety Disorder (GAD). Meditation is one of the therapies prescribed to manage GAD. Many people suffer from anxiety, and it affects their output in different work environments. It also affects mental health that could limit an individual's life and wellness. Many patients suffer from GAD, and the effects increase, especially in the hospital environment. It could be due to the nature of procedures they are meant to undergo and the financial burden that certain treatment plans are likely involved in. Additionally, the likely outcome from a diagnostic test or treatment plan could heighten anxiety. This paper explores meditation and its effects on anxiety. 

Subjects for this study will undergo a weekly corporate meditation exercise. Meditation has been beneficial in managing the Intermittent Explosive Disorder (IED), a disorder that is related to effects of anxiety. Triggers are from the social environment and a buildup of internal issues. Approximately 7.3% of all American adults suffer from IED. After the study participants undergo the weekly meditation exercise, parameters of justifiable anger, annoyance, and violence will be recorded. The study subjects will also participate in an alternate nostril breathing training to manage anxiety. This intervention is time-tasted and helps subjects to relax the body and mind. It also helps reduce anxiety and promote the subject's well-being when he/she practices it regularly. It is recommended that exercise is done daily to build consistency and calmness. 

Project Rationale 

Anxiety is characterized by the worry that is often uncontrollable. Other notable symptoms include muscle tension, irritability, and poor sleep. The prevalence irritability rate of irritability for patients diagnosed with anxiety is about 5.7%. The most common approaches to managing this condition usually are pharmacotherapy and psychotherapy. However, these approaches do not achieve complete remission. The remission from previous studies stood at 15% for these interventions, as Hoge et al. (2013) write. At the same time, most patients suffering from this condition may not seek psychotherapy due to perceived stigma in most management centers. 

Therefore, any registered nurse must consider and evaluates their patients for anxiety since it affects the outcomes. Ideally, developing new meditation initiatives and measures to manage anxiety can complement the clinical treatment plan and improve outcomes. It is also expensive to manage anxiety, especially for patients who do not have comprehensive insurance covers or those who are not enrolled on Medicare. Given these considerations, the challenge is to find another alternative therapy that is cost-effective and one that will achieve better remission rates. 

Patients are likely to benefit from a meditation exercise and alternate nostril breathing as many studies report. The project will take an evidence-based approach through weekly meditation sessions combined with alternate nostril breathing training to relieve anxiety. If the results indicate a decrease in the degrees of the recorded parameters, then it will reflect that meditation exercises were beneficial and the project will be evaluated as successful. 

Personal/Professional Expectations 

From this project, I expect to gain experience in diagnosing anxiety and developing comprehensive meditation treatment plans with interventions that can be combined to improve my subjects and my patients' remission rates later in practice. It will be important to understand the best way to conduct corporate meditation exercises and alternate nostril meditation to achieve the best results throughout the 7 sessions of study. Patients suffering from anxiety need support; therefore, I will give good demonstration and evaluate how the subjects practice meditation and the cycles to enhance alternate nostril breathing intervention benefits. In the end, I will give recommendations that will be peer-reviewed and help enhance information from other research findings. 

Project Goals 

Meditation is key to help improve healthcare access for patients battling anxiety. Since meditational interventions are low on stigma, it will be successful to note increased health-seeking behavior from this group of patients. Moreover, this project will aim to achieve increased remission rates of anxiety through meditation for subjects suffering from anxiety compared to preexisting therapies. 

The nursing team will be critical in studying the enrolled participants to determine other signs that could be descriptive of anxiety in the short-term. A complete assessment of study outcomes from the recorded parameters on the self-report questionnaires will form a basis for the results upon which I will draw recommendations. For the study, it will be important to note the variation of parameters prior to the meditation exercise and after and then make a comparison with outcomes with other similar studies applying combinational therapies in managing anxiety as a step further. 

Analysis of the Literature 

As Chen et al. (2013) notes, g uided meditation and can be felt quickly. The approach can help change perspective and shift a subject's mood in a few minutes. These effects can reduce the signs of anxiety and help a subject cope with potentially overwhelming situations. The technique also combats fear and can help a subject remain grounded. Connecting the breath has proven to be unnerving every time patients focus on their sessions as they meditate ( Chen et al. 2013) . This way, meditation helps reduce the heart rate and help subjects understand themselves, their reactions, emotions, and rediscover themselves. 

Chen et al. (2013) note that mindfulness-based interventions are gaining recognition of top nursing practitioners. One of the most recommended intervention is alternate nostril breathing. This intervention is cost-effective, less likely to stigmatize patients, and could encourage patients' health-seeking behavior for shunning treatment centers for psychotherapy due to stigma. The technique can be done at home or any comfortable space that allows a subject to concentrate on taking breaths. Mindfulness training helps participants develop meditation techniques that will help them boost awareness of their current experiences, including their emotions, thoughts, and bodily sensations (Chen et al., 2013). The alternate nostril breathing technique for meditation helps patients have a better and gentle, accepting attitude towards themselves. 

According to Goldin et al. (2009), patients suffering from anxiety also have lower trait mindfulness levels and even compart difficulties regulating their emotions. It is worth noting that many studies have been carried out to deduce the effect of mindfulness meditation on anxiety. However, these studies have limitations since they are small, and they often have no participants enrolled as attention controls for non-specific effects resulting from meditation interventions (Goldin et al., 2009). Therefore, it becomes difficult to account for group support effects, the likely expectancy bias, and instructor attention. 

A recent meta-analysis established a moderate effect size for interventions based on mediation. To add on, other evaluations and meta-analyses have also found profound deficits in methodology for studies employing mediational interventions. Some reviews include the Cochrane review that cautions implementation before conducting full randomization and controlling data to ascertain efficacy (Hazlett-Stevens, 2019). For this project, it will be important to randomize it and have an isolated group with combinational interventions that include cognitive therapy. Also, since many studies have gaps in terms of how participants receive support from instructors, there will be sufficient support that will also include group support and complete meditation training. 

Other researchers have actively added Mindfulness-Based Stress Reduction (MBSR), which has shown a sufficient decrease in stress for patients with panic disorder, GAD, and social anxiety disorder. Other teams have deployed Mindfulness-Based Cognitive Therapy (MCGT) and have noted a reduction in anxiety levels (Gu et al., 2016). The major problem that these teams have had is comparing the effects to suggest the best therapy. For my study, I will have a group enrolled for alternate nostril breathing training to find the proportion of effect after the therapy is applied. I will then compare the results with other combinational intervention studies such as MBCT in the data analysis. It will, therefore, make the study comprehensive and complete. 

Procedure 

I will seek the approval of an institutional review board for the procedures allowing faculty members' participation. The self-report questionnaires will be completed before and after the meditation sessions. The patients will then undergo randomization by cluster to join alternate nostril breathing training. In order to maintain IE blinding, I will recommend that participants receive clear instructions to avoid discussing the subject matter about their classes with the nurses who will be evaluating them. 

Corporate Meditation Exercises 

As the lead instructor, I will begin by asking the participants about their expectations throughout the study and their perceived outcomes at the end. I will encourage them to support each other and to respectfully engage throughout the meditation exercise. For this exercise, a slow and conscious breathing technique will apply as an ideal starting point. Participants will find a comfortable position where they will sit, close their eyes and begin to consciously and gradually focus on their slow breathing (Explore Meditation & Jingo, 2018). They will then take deep breathes and then breathe out slowly. After complete exhalation, they will pause and take some moments to settle into their bodies. It will help them acknowledge their senses and understand how well they can use their senses for perception. For the next step, participants will be required to scan their bodies in cycles of 20 seconds and establish that they have a feeling of total relaxation. Subjects will then evaluate their levels of awareness and the underlying mood without altering it. They will get back to breathing while observing the rising and falling sensation in their bodies. It will be key to focus on the quality of the breath whether it is short or long, and shallow or deep. They will then count inhales and exhales up to 10. 

Towards the end, the participants will sit for about 20 to 30 seconds and relax allowing their minds to be free. As they finish, they will concentrate on their awareness from their senses to anything physical including their postures. During other sessions, it will be prudent to introduce a few concepts to meditation exercises. The subjects can work on each body part by focusing on their lower les, the upper legs, the face and the entire body. 

Alternate Nostril Breathing 

For participation in the randomized MBSR group, the instructor will guide the subjects to take deep breathes and meditate; for this exercise, the instructor will use alternate nostril breathing for the study subjects. The study subjects are 20 faculty members comprising clericals, Teacher assistants, nurses, and teachers. However, one participant requested to drop out of the study for personal reasons and was allowed to. The remaining 19 study subjects will then take a 7-week meditation training and fill up a questionnaire before the sessions and after the sessions. The reporting on anxiety levels will determine whether alternative nostril breathing is an effective anxiety-relieving intervention. 

The participants will settle on comfortable seats and pose with straight spines with open hearts. They will relax the left palm on the lap and have their right hands just in front of their faces. The middle and pointer fingers will then relax between the eyebrows and act as light anchors with the right hand. The ring finger and the thumb will be actively used in this process. The subjects will then be asked to close their eyes and then take deep breathes. Using the right thumbs, they will the right nostrils and steadily but slowly inhale through the left nostril. In the next step, the subjects will close the left nostrils using the ring fingers such that now, all nostrils are closed. They will then retain their breaths at maximum inhalation volume briefly, after which, they will release the right nostrils and breathe out slowly with a pose at the end. They will then slowly inhale through the right side and close all their nostrils once more. Alternatively, they will release the left nostril and release the breath with a similar pose at the end. With less than ten repeated cycles, they will allow the mind to follow the cycles of breathing. As an instructor, I will demonstrate and allow the subjects to repeat until they become perfect for this therapy. Alternate nostril breathing will help the subjects achieve calm and concentration to help them whenever they feel tense. Repetition improves the outcome each time throughout the program. 

Evaluation 

Clinical outcome measures will determine the success of the application of meditation and its effects on anxiety. Data analysis will be performed from the university using a program such as STATA version 11.1. The analysis will be conducted for an intent-to-treat sample with n=20 as the number of subjects enrolled and having participated in at least a single session. The primary and secondary outcome variables will be defined with a mean imputation method to account for measures having 15 percent or missing elements. 

Measure analysis of variance with time will be taken and calculations made from baseline to the endpoint. Each variable, such as quality of sleep and calmness levels reported by the patients, will be used. It will be important to follow up on the study subjects daily for data analysis. It will be simple to do data collection and coordinate the training since the subjects are faculty members. Data analysis and documentation will be carried out from the institutional offices. Datasheets with bar graphs will compare the outcome based on the reporting of parameters before and after meditation exercises and nostril breathing training. 

References 

Chen, Y., Yang, X., Wang, L., & Zhang, X. (2013). A randomized controlled trial of the effects of brief mindfulness meditation on anxiety symptoms and systolic blood pressure in Chinese nursing students.  Nurse Education Today ,  33 (10), 1166-1172. 

Explore Meditation & Jingo. (2018, November 26). Relaxation Techniques . Explore Meditation. https://www.exploremeditation.com/relaxation-techniques/. 

Goldin, P., Ramel, W., & Gross, J. (2009). Mindfulness meditation training and self-referential processing in social anxiety disorder: Behavioral and neural effects.  Journal of Cognitive Psychotherapy ,  23 (3), 242-257. 

Gu, J., Strauss, C., Bond, R., & Cavanagh, K. (2016). “How do mindfulness-based cognitive therapy and mindfulness-based stress reduction improve mental health and wellbeing? A systematic review and meta-analysis of mediation studies": Corrigendum. 

Hazlett-Stevens, H., Singer, J., & Chong, A. (2019). Mindfulness-based stress reduction and mindfulness-based cognitive therapy with older adults: a qualitative review of randomized controlled outcome research.  Clinical Gerontologist ,  42 (4), 347-358. 

Hoge, E. A., Bui, E., Marques, L., Metcalf, C. A., Morris, L. K., Robinaugh, D. J., ... & Simon, N. M. (2013). Randomized controlled trial of mindfulness meditation for generalized anxiety disorder: effects on anxiety and stress reactivity.  The Journal of Clinical Psychiatry ,  74 (8), 786. 

Sears, S., & Kraus, S. (2009). I think therefore I am: Cognitive distortions and coping style as mediators for the effects of mindfulness meditation on anxiety, positive and negative affect, and hope.  Journal of Clinical Psychology ,  65 (6), 561-573.