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The study assesses integrative medicine intervention effects on healthcare providers' quality-of-life during wartime.
The study is prospective, non-randomized and non-controlled, and taking place at the Carmel Medical Center in Haifa, northern Israel, from October 2023. The study was launched in proximity with the outbreak of the October 2023 war in the Middle East. As this timing was and is still regarded in Israel as an emergency life-threatening situation and considering the research limitation to healthcare providers only, the Carmel Medical Center Institutional Review Board has exempted the study from requiring written consent from participants, after reviewing the study protocol. However, Participation in the study was voluntary, and no incentive, financial or other was offered.
The hospital administration and department refer healthcare providers (HCPs) to integrative medicine intervention those if reporting emotional, physical, or other QoL concerns directly or indirectly related to the current conflict in Israel. The IM intervention entails a 30-minute treatment session, with an additional 10 minutes allocated for both pre- and post- treatment assessment. IM treatments are individually tailored to the HCP's QoL-related concerns, taking into consideration their willingness to undergo the recommended modalities. In all cases, a multi-modal IM program is recommended, which includes at least one of the following: acupuncture; manual-movement therapies (e.g., acupressure, Anthroposophic medicine touch therapies, reflexology, Qi Gong, and Feldenkrais method); and mind-body medicine (e.g., relaxation and breathing techniques). During these treatments participants are asked to lay on a treatment bed, with relaxed non-paced breathing throughout the session. The IM treatments are provided by IM-trained therapists who work in an integrative oncology setting.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Integrative medicine intervention | Experimental | Healthcare providers were treated for 30 minutes with integrative medicine based on manual and mind-body modalities |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Integrative medicine including manual and/or mind-body treatments | Other | Referred HCPs are recommended a multi-modal IM program, include at least one of the following: acupuncture; manual-movement therapies (e.g., acupressure, Anthroposophic medicine touch therapies, reflexology, Qi Gong, and Feldenkrais method); and mind-body medicine (e.g., relaxation and breathing techniques). |
| Measure | Description | Time Frame |
|---|---|---|
| Assessing HCPs QoL-related concerns using the Measure Yourself Concerns and Wellbeing (MYCAW). | The MYCAW asks patients to list their two most significant concerns and general feeling of wellbeing (from 0, "doesn't bother me at all"; to 6, "bothers me greatly"). At post-treatment, the HCPs are asked to re-score the two original leading concerns and general well-being, followed by two open-ended questions about "Other things affecting your health"; and "What has been most important for you?" with respect to the IM treatments they had received. In the post-intervention narratives, HCPs are asked to describe the most important aspects of their treatment. HCP narratives are considered as free-text narratives, which may be qualitatively analyzed using ATLAS.Ti software for systematic coding, to identify clusters of emotional-spiritual keywords (ESKs), such as "calming", "release", "relaxation" and "disengagement". | Before and immediately following the IO intervention; and at 24-48 hours post-treatment. |
| Assessment of objective physiological changes during the intervention | Assessment of objective physiological changes during the 30-minute intervention are conducted using chest-lead electrocardiogram monitoring autonomic heart rate variability (HRV) throughout the intervention. | During the 30 minutes intervention |
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Inclusion Criteria:
Exclusion Criteria:
* Healthcare providers with no quality-of-life related concerns they attribute to the war r
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Eran Ben-Arye, MD | Contact | +972528709282 | ERANBE@clalit.org.il | |
| Sameer Kassem, MD | Contact | +972508573244 | samirqa@clalit.org.il |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Carmel Medical center | Recruiting | Haifa | Israel |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 35383045 | Background | Ben-Arye E, Gressel O, Samuels N, Stein N, Eden A, Vagedes J, Kassem S. Complementary and integrative medicine intervention in front-line COVID-19 clinicians. BMJ Support Palliat Care. 2022 Apr 5:bmjspcare-2021-003333. doi: 10.1136/bmjspcare-2021-003333. Online ahead of print. | |
| 36346679 | Background | Vagedes J, Kassem S, Gressel O, Samuels N, Eden A, Ben-Arye E. Parasympathetic Versus Sympathetic Changes in Heart Rate Variability After a Multimodal Integrative Medicine Intervention for Frontline COVID-19 Personnel. Psychosom Med. 2023 Jan 1;85(1):53-60. doi: 10.1097/PSY.0000000000001153. Epub 2022 Nov 9. |
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| ID | Term |
|---|---|
| D015670 | Acupuncture Therapy |
| D019050 | Acupressure |
| ID | Term |
|---|---|
| D000529 | Complementary Therapies |
| D013812 | Therapeutics |
| D064746 | Therapy, Soft Tissue |
| D026201 | Musculoskeletal Manipulations |
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| 40511976 | Derived | Kassem S, Vagedes J, Gressel O, Samuels N, Elias S, Ben-Arye E. Spirit and Sense: Autonomic Response to Integrative Medicine Intervention for Health Care Personnel During Wartime. Biopsychosoc Sci Med. 2025 Jul-Aug 01;87(6):380-387. doi: 10.1097/PSY.0000000000001402. Epub 2025 Jun 11. |
| D026741 | Physical Therapy Modalities |
| D012046 | Rehabilitation |