Shamanic Healing for Women with TMD

描述(由申请人提供)：传统的治疗系统，如萨满教，不容易适用于传统的研究方法，但研究其有效性尤其适用于涉及情绪因素的慢性疾病，并逃避对症治疗制度。影响多达10%成年人口的颞下颌关节紊乱病(TMD)就是这种情况的一个典型例子。传统的治疗TMD疼痛的结果往往不令人满意。此外，在25-55岁的女性(年龄-性别影响最大)中，TMD经常被发现与抑郁、焦虑、睡眠障碍、胃肠道症状、频繁感染和纤维肌病有关。由于这些多重而复杂的症状暗示着精神或生命能量的丧失，他们可能特别容易受到萨满(精神)治疗的影响，萨满治疗的目的是使紊乱的身体、精神和情绪系统达到平衡。俄勒冈州补充和替代医学研究中心(I-P50-AT00076)正在进行两项临床试验，以评估TMD的替代方法，这项第一阶段的研究建议开发方法来评估萨满治疗作为TMD的干预，并评估进行萨满治疗的随机临床试验的可行性。 拟议的研究将1)设计一个实施萨满治疗干预的方案，可用于未来的临床试验，包括招募策略、数据收集工具和程序，以及萨满治疗方案；2)对25名患有TMD的女性实施单臂、岗前设计方案，评估参与意愿、参与者和萨满从业人员的可接受性、数据收集的可行性和分析策略；3)评估参与者的治疗结果，包括与TMD相关的疼痛和残疾的临床和自我报告测量、其他症状的变化和安全性；4)评估萨满教作为一种治疗系统的内容，包括如何识别“相似的诊断”，以评估不同萨满教从业者对同一患者诊断的一致性。这些目标的成功完成将有助于程序、方法和数据，从而产生具有竞争力的R01应用。

DESCRIPTION (provided by applicant): Traditional systems of healing, such as shamanism, do not readily lend themselves to conventional research methods, yet studying their effectiveness is especially germane in the case of chronic conditions that involve an emotional component and that elude allopathic treatment regimes. Temporomandibular joint disorders (TMDs), which affect up to 10% of the adult population, are a prime example of such conditions. Traditional treatment outcomes for TMD pain are often unsatisfactory. Moreover, in women age 25-55 (the age-sex group most affected), TMD is often found in association with depression, anxiety, sleep disturbances, gastrointestinal symptoms, frequent infections, and fibromyaigia. Because these multiple and complex symptoms suggest a loss of spirit or life energy, they may be particularly susceptible to treatment by shamanic (spiritual) healing, which aims to bring disturbed physical, mental, and emotional systems into balance. In conjunction with the Oregon Center for Complementary and Alternative Medicine Research (I-P50-AT00076), which is conducting two clinical trials to evaluate alternative approaches to TMD, this Phase I study proposes to develop methods to evaluate shamanic healing as an intervention for TMD and to evaluate the feasibility of conducting randomized clinical trials of shamanic healing. The proposed research will 1) design a protocol for implementing a shamanic healing intervention that could be used in future clinical trials, including recruitment strategies, data collection instruments and procedures, and shamanic healing protocols; 2) implement a single-arm, pre-post design protocol with 25 women with TMD, evaluating willingness to participate, acceptability to participants and shamanic practitioners, feasibility of data collection, and analysis strategies; 3) evaluate the outcomes of the treatment for the participants, including clinical and self-report measures of TMD-related pain and disability, change in other symptoms, and safety; and 4) evaluate the content of shamanism as a healing system including how to identify "similar diagnoses," to estimate the consistency of shamanic diagnoses by different shamanic practitioners on the same patient. The successful completion of these aims will contribute procedures, methods, and data that will lead to a competitive R01 application.