Objectives: This study aims to describe the characteristics of published peer-reviewed journal articles authored by naturopathic practitioners (NPs) Design: The study used bibliometric analysis of data extracted from journal articles. Settings/Location: International Subjects: Articles were included if they had at least one author with a naturopathic qualification and were published in a peer-reviewed, indexed journal. Data collection: A snowballing method was used between June 2018 and July 2019 to identify relevant articles. Outcome measures: Data related to geography, affiliation, year of publication, article type or research design, article topic, and journal were extracted from each included article. Results: Identified articles (n = 2,218) were published by NP from 22 countries between 1987 and 2019, with 80.9% published in the last 10 years. Most articles were published by NP from the America (52.5%) and Western Pacific (28.3%) World Health Organization regions. The most common type of study design or article type was reviews and meta-analyses (23.2%) and clinical trials or intervention studies (19.4%). Explicit mention of naturopathy was reported in 8.1% of articles. Almost half (48.4%) of all included articles were published in 40 journals, and 56.9% of these were published in journals ranked in the first quartile of at least one subject area. Articles focused on mental health were more likely to be conducted in Australia (odds ratio [OR] 3.3) and focused on lifestyle behavior (OR 2.5) or clinical nutrition (OR 1.6). Articles about cancer or cancer-related conditions were more likely to include lifestyle behavior (OR 2.0) and less likely to be conducted in Australia (OR 0.1) or Germany (OR 0.5). Conclusions: The international naturopathy research community has produced peer-reviewed literature for over 30 years and has demonstrated sustained commitment to codifying existing knowledge, generating new knowledge, and disseminating this knowledge to the wider clinical and research community.
Objectives: State (situational) anxiety can create suboptimal outcomes for patients across a variety of health care specializations. While anxiolytic medications reduce anxiety, problematic side effects can compromise outcomes. These challenges have spurred searches for nonpharmaceutical approaches to alleviate patient anxiety. This systematic literature review, largely following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, aimed to determine patterns and effectiveness of interventions across medical health care specialty areas, including dentistry. Methods: A systematic review was conducted, using PubMed, CINAHL, and PsycINFO databases, with search terms related to anxiety, specific interventions, and medical or dental procedures. Hand searching for additional citations was performed on the bibliographies of dissertations, meta-analyses, and systematic reviews that met article inclusion criteria. The search process yielded 48,324 articles and 257 dissertations published in English between 1974 and 2018. Each abstract was evaluated for inclusion by two reviewers, yielding 718 articles that were read and evaluated for outcomes, risk of bias, pretest and post-test, controls and quality, using a Critical Appraisal Skills Programme instrument. Of these, 408 articles, describing 501 experimental trials, were accepted for inclusion in this analysis. Results: A total of 50,343 patients were included in these experiments, with an overall success rate of 71% for reducing patient anxiety. Results are summarized by health care specialty area: surgery, oncology, cardiology, obstetrics/gynecology, dentistry, and pain/trauma, and the following diagnostic testing and intervention areas: imaging, colonoscopy, mechanical ventilation, and other. The largest number of experiments (114) was in the surgery category. The types of interventions included music, education, relaxation, cognitive behavioral therapy (CBT), massage, distraction, hypnosis, acupuncture/acupressure, social support, aromatherapy, nature sounds, natural visual stimuli, special garment, and other. The largest numbers of experiments were done with music (143) and education (130). Discussion: The following interventions were most successful, reducing anxiety in over 70% of experiments: music, CBT, relaxation, massage, acupuncture/acupressure, hypnosis, and natural sounds. Confidence in results is limited by publication bias, small sample sizes, and the lack of placebo controls. Directions for future research are discussed.
