• 80 • Chin J Integr Med 2010 Feb;16(1):80-86

REVIEW
Yoga and Qigong in the Psychological Prevention of Mental
Health Disorders: A Conceptual Synthesis
Paul Posadzki1, Sheetal Parekh2, and Nel Glass3

ABSTRACT The study proposes to explore two alternative medicine therapies—qigong and yoga for balanc-
ing the essential duo of holistic mind-body and consequently offer a solution for stress, uncertainty, anxiety and
depression. Qualitative research methods have been used to create a conceptual synthesis of yoga and qigong.
It is suggested that an increased sense of control is the interface between these two modalities. This conceptual
congruence of qigong and yoga is thought to be a selective, curative method, a prescription for ideal living and a
ground of human essence existence. Furthermore, this essence is thought to enhance the mind's self-regulatory
processes and prevent mental health disorders. The two alternative therapies can prevent mental health disor-
ders such as anxiety, depression and, minimize mental health disruptions such as stress and poor quality of life.
It is suggested that patients and/or clients can benefit from this fusion.
KEY WORDS yoga, qigong, mental disorders, concept formation

Maintaining mental health is now thought to be alternative medicine therapies-qigong and yoga as a
an ongoing challenge, especially since humans live in means to balance the essential mind-body interactions
environments that create stress, depression, uncertainty and offer a solution to stress, uncertainty, anxiety and
and anxiety, all of which have potentials to lead to depression. It is asserted that the "essence" of these
substance abuse, emotional and physical pain, anger exercises would promote self-discovery and enhance
and violence. It has been suggested that hundreds of well-being, where, individuals develop more flexibility and
millions of individuals around the globe are affected by adaptability in their thoughts, emotions and behaviors.
these disorders(1). According to the WHO, individuals with The end result would increase mental health awareness,
these disorders are often exposed to social isolation, self-organization, will powers and self-discipline through
poor quality of life and increased mortality because an increased sense of self-control during various body
mental health policies and community intervention movements and postures, such as qigong and yoga
and treatments remain inadequate, resulting in respectively. The aim of this study is, therefore, to
marginalization of individuals with mental illness. To add explore the psychological benefits of qigong and yoga
to this problem, the current literature has reported that exercises, describe their "essence" through the lens of
the costs of inpatient mental health care are escalating; their underlying concepts and investigate how patients,
demanding that the duration of inpatient admission be healthcare professionals or teachers can benefit from
reduced and that individuals with mental health disorders this synthesis in terms of the promotion, prevention, and
should be treated predominantly in the community(2,3). development of the mental health.
Furthermore, the number of individuals diagnosed with
mental illness is increasing(4-8). It has been stated that Brief Characteristics of Yoga
12.3% of the world's total population are affected by Yoga originates and has its root in Ayurveda,
mental health disorders with an expected rise of 15% by
2020(9). Disturbingly, most of these disorders might be
misdiagnosed and not treated consequently and it can be
1. University of East Anglia, School of Medicine, Health Policy
a life-threatening matter when individuals become aware and Practice, NR4 7TJ, Norwich, Norfolk, UK; 2. University of
that mental health disorders can interchangeably affect East Anglia, School of Allied Health Professions, NR4 7TJ, Nor-
wich, Norfolk, UK; 3. Nursing Research Unit, ACU National/St
patients in conditions of chronic disease, such as cancer, Vincents and Mercy Private Hospital, Fitzroy, VIC, Australia
heart diseases, diabetes mellitus and AIDS. 3065
Correspondence to: Dr. Paul Posadzki, E-mail: P.Posadzki@
uea.ac.uk
In this paper the authors intend to propose two DOI: 10.1007/s11655-009-9002-2
Chin J Integr Med 2010 Feb;16(1):80-86 • 81 •

namely its philosophical approach is that ancient knowl- improve coping and stress management(28) among yoga
edge about life aims to discover the true sense of hu- practitioners. Literature has also indicated results with
man existence and remedies for diseases. The main aim quality of life. For instance, it has been documented
of yoga is self-realization, self-exploration and bless- that there are significant improvements in quality of life
consciousness through consciousness control(10). Whilst scores(29).
yoga has been in existence for four to five thousand
years, mainly in Asia it has not yet become a part of The authors would argue that this proliferation of
complementary and alternative medicine. literature is indicative of the vast potential of this healing
exercise. Therefore, it is advocated that yoga can be
Benefits of Yoga: Psychological and Spiritual Wellness implemented daily in order to actively control one's own
Scholars have documented that yoga asanas thoughts, feeling, emotions and behaviours. This sense
has resulted in a significant reduction of the symptoms of control over one's own existence may strengthen the
of anxiety and depression (11-15). It has been reported essence of individuals' being, prevent mental health
that yoga can also decrease oxidative stress(16) and disorders, and develop positive health states.
relieve tensions, leading to better relaxation and
concentration(17-19). Shannahoff-Khalsa has demonstrated Brief Characteristics of Qigong
that yoga asanas increases dopamine and serotonin Qigong is also a form of complementary therapy
and decreases the secretion of cortisol, and thereby and a method of health improvement, both efficient and
contributing to joy and happiness(20, 21). effective(30). Qigong, referred to as Chinese health exer-
cises, has been used and developed for thousands of
Yoga techniques have been found to be effective in years to optimize energy within the body as a whole(31).
treating obsessive-compulsive disorder, phobias, major Qigong is a combination of meditation, controlled breath-
depressive disorders, dyslexia, grief, sleep disorders ing and gentle, physical movements designed to direct
including insomnia(20) and post-traumatic stress disorder mental attention to specific areas of the body. It may
(PTSD) (22). Yoga can also improve fear management improve physical and mental health(32,33). The qigong ex-
through its ability to create soothing effects. Yoga has perts frame it as a "mind-in-body" practice rather than
also been advocated in controlling anger and assisting mind-body interaction.
in coping with mental health challenges, helping
patients to transform negative thoughts into positive Psychological Benefits of Qigong Exercises: Qigong and
ones; and facilitating rehabilitation of patients prone to Central Nervous System
anti-social behaviours(23). Therefore, yoga offers a new Qigong exercises may be regarded as "brain gym-
route to positive mental and physical health and helps nastics" affecting the mind's homeostasis. Psychological
to free individuals from drug dependency (addictive outcome of qigong practice includes perceptual changes
and substance abuse disorders)(24) and its associated such as individuals' experience of chilliness, relaxation,
problems (25). Yoga techniques have been reported to tenseness and floating(34), sense of harmony, tranquillity
enhance well-being, mood, mental focus, and stress and serenity(35). It also positively affects the mood chang-
tolerance(23,26); can help promote personal development, es and relieves exhaustion and tension(36). Qigong helps
by encouraging individual initiative and self-belief; to normalize, stabilize and sustain positive and pleasant
and can help to bring about improvements in attitude emotional states of human mind(37), thereby improving the
and health behaviour (25). Yoga asanas are regarded overall well-being of individuals. It also relieves depres-
as an open door to self-realization and creation of sion in chronically physical illness sufferers by improving
the perfect union of the mind, body, and spirit (27) . the individual's self-identity, social well-being and quality
Some of the beneficial effects enjoyed by the yoga of life(38,39). A major development of the perception of self-
practitioners are a statistically significant improvement efficacy has also been observed(40). From a health re-
in various parameters such as better sense of mental source perspective, qigong may improve an individual's
well-being, self confidence, improved effectiveness, sense of coherence, regain a sense of safety and active
more satisfying interpersonal relationships, increased control, and can be a specific stress coping strategy(41).
attentiveness, lowered irritability levels and an optimistic Qigong training was found to result in decreased long-
outlook in life(12). It has also been cited that significant term anxiety and pain reduction in the general popula-
improvements in perceived self-efficacy may also tion(42, 43). This can be partially explained by Ryu, et al, as
• 82 • Chin J Integr Med 2010 Feb;16(1):80-86

the authors observed the effects of qigong training on the effects on individuals' health and well-being, affecting the
levels of human endogenous opioid peptides, such as integration of mind-body-spirit(51-55).
beta-endorphin, and other stress hormones adrenocorti-
cotrophic hormone (ACTH)(44). The levels of beta-endor- Anxiety
phin were significantly increased during the mid-time of Anxiety can be defined as a state of apprehension,
training, while the level of ACTH declined at the mid and fearful uncertainty, or dread caused by anticipated
post-time of training. The results have suggested that threats. It is often accompanied by increased sympathetic
qigong training, when used as a stress coping method, nervous system activities, i.e. shortness of breath,
affects and plays a role in hormonal regulation related to rapid heartbeat, sweating and trembling(56). Spielberger
the maintenance of homeostasis in humans(44). Results distinguished anxiety as a "state" varying over time and
obtained by Jones have indicated that the blood levels situation, and as a "trait" stable over time(57). It is also
of the stress-related hormone cortisol may be lowered being suggested that some individuals tend to feel afraid
by short-term practice of qigong as well(32). Qigong may even when there is no present objective threats, known
cause changes in brain functioning, for example, theta in the health care industry as subjective anxiety(58). The
rhythm frequencies, levels of concentration(45). Another following anxiety disorders can also be distinguished
study showed that the practice of qigong helped in the such as panic attacks, phobias, generalized anxiety
rehabilitation of drug addicts(46). Additional research has disorder, obsessive compulsive disorder and PTSD(59).
also shown that qigong may be an effective alternative The same authors have claimed that these disorders are
for heroin detoxification without side effects(47). A few extremely dangerous and difficult to treat. In a similar
positive impacts on various dimensions of human mind tone, Malim and Birch have claimed that avoidance of the
functioning proposes a huge potential of qigong in main- stimulus is a method that individuals often use to reduce
taining health related goals. The above results suggest anxiety(60). Nevertheless, this means that the real source
that qigong's underlying principles can influence "mental of anxiety is never conquered.
homeostasis through increased sense of control over soft
and gentle movements performed with full attention. This Depression
sense of control over one's own body-mind as a whole Major depressive episodes are characterized by
(thoughts, feelings, emotions, and perception of own self feelings of worthlessness, indecisiveness and disturbed
within here and now), while practicing qigong may be physical symptoms such as altered sleeping, eating and
"used" to prevent mental disorders such as depression, drinking and a larger decrease in energy for at least two
anxiety or stress. Additionally, it may be used to develop weeks in duration(61). All mood disorders remain a signifi-
positive emotional "reactions" such as happiness, joy cant health care issue especially as there is often undue
and love, intelligence, creativity, or total mental well- pressure on individuals within Western societies to per-
ness(32, 43, 44). form. Depression can take different forms and it can also
be expressed as sudden lost of interest in life, energy
Mental Health Disorders an drive, lack of positive emotions and mood, impaired
According to WHO (2001), the following mental cognitive processes such as memory or thinking, or intel-
health disorders, i.e. stress, anxiety, depression are a ligence(62). An affected individual may have delusions and
serious threat to the overall populations' well-being(1). In /or behavioral implications including suicide ideation and
the next section of this article, a brief description of these attempts.
disorders will occur.
It is therefore argued that these three pathologies
Stress indicate that affected individuals suffer considerably and
The notion that stress can cause serious need comprehensive skilled health care intervention
psychopathology is in inherent in both common thinking help from healthcare professionals. Therefore, nurses,
and formal theorizing(48, 49). According to Lazarus and physiotherapists, rehabilitation specialists, doctors
Folkman stress can be perceived as an interaction are in well positioned to support patients in their
between the individual and the society(50). This interaction experiences of grief provided they are supported in their
may have negative connotations only when it is appraised own integration of body, mind and spirit(63-67). Several
as challenging, dangerous or threatening. Additionally, explanations of how this can be accomplished will be
prolonged stress may induce a constellation of harmful presented below.
Chin J Integr Med 2010 Feb;16(1):80-86 • 83 •

Yoga and Qigong and Exercises-Congruence of Their ity. Therefore, an individual can simultaneously become
Essence aware of the psychological processes of conscious atten-
It can be claimed that an increased sense of control tion, mindfulness, thoughts, feelings and emotions and
is conceived to be selective, curative; a method, a pre- the body's position in space and time and surrounding
scription for ideal living, a ground for human existence circumstances in terms of movements and postures. It is
and the essence of both yoga and qigong exercises. This this that results in a stronger sense of control over one's
increased sense of control could also be thought as a de- own mental health.
velopment of inner wisdom that lead to the fullest sense
of control over self-actualisation and self-realisation. The The nature and essence of the increased sense
essence of yoga and qigong exercises could also lead an of control over body movements and postures could
individual to self-exploration in the direction of enhanced therefore be explored by the individual to prevent stress,
self-organization and self-control at the personality level anxiety, and depression, and promote mental health and
to prevent emotional fluctuations, states of uncertainty well-being. Of course, an individual performing a particu-
and lack of confidence, obsessive thoughts, unhealthy lar movement or the body's posture must be fully aware
behaviors, such as substance use and poor attention to of their potentials in order to completely "use" it. That is
mental health. the reason why consciousness is thought to be the de-
nominator of all processes within the human body and a
The Conceptual Synthesis for the Prevention of state when one realizes this potential through the sense
Mental Health Disorders of control over own movements and postures. It can also
The authors have chosen these two modalities and be suggested that the conscious process of self-control
their conceptual convergence for prevention of mental during movements and postures might be and should be
disorders (MD) because it is believed that both modali- pleasant, fascinating and passionate and should be de-
ties have a similar quintessence, that is, control over own veloped to prevent mental health disorders. Furthermore,
body's movements and position in space, with conscious it can be suggested that the individual should move to-
integration of emotions and thoughts and mind-body- wards living in an open, friendly, close relationship to his
spirit. The authors would strongly argue that such con- own experience—the sense of control. The quality of
ceptual convergence is the interface between these two such sense of control influences the nervous system pos-
practices. itively as the body movements and postures performed
with full awareness, state of unity within reality and self
The conceptual synthesis of these two modalities may be an optimal way for self-discovery, self-exploration
is based on the assumption that the human mind pos- and overall development. Both qigong and yoga can be
sesses huge positive resources, which enable individuals regarded as potential methods or ways of conscious self-
to obtain its maximum potentials through the sense of development and self-realization through an increased
control over movements and postures. Therefore, imple- level of self-control.
menting these "health promotion exercises" with the
explicit aim being to improve and simultaneously prevent Implications for Practice
mental health disorders can consciously alter the body's It is proposed that the increased sense of control
self-regulatory process. over oneself during these activities could form part of
healthcare practitioners' plans and more broadly clinical
Conceptually and in practice, both qigong and Yoga management of their hospitalized and community
promote awareness and recognition of communication patients. This could improve patients' mental capacities
between thought and action, emotions and movements such as level of optimism, sense of coherence, positive
and body posture and relaxation. Both exercises, if used thoughts and emotions and conscious control over one's
regularly, can result in effortless concentration, self- awareness. Consequently, coping stress strategies
actualization and self-realization in the present, thereby, and resources as well as an overall health, well-
facilitating an individual's sense and ability to control being and quality of life could be enhanced. Such an
their own body's processes. Through this concept the approach could strengthen the healthcare professionals'
sense of self-control over one's mental health state can own holistic health and mental qualities. The authors
be achieved, particularly when one realizes their intrac- also believe that this could develop therapist-patient
eption and extraception simultaneously within this real- relationships.
• 84 • Chin J Integr Med 2010 Feb;16(1):80-86

In relation to health care professionals, the authors may give potential insight into the potential relationships
would advocate that performing qigong and/or yoga between qigong and yoga exercises in the light of their
would be a conscious and constructive strategy to man- essence-an increased sense of self-control. It can be
age their own work related stress. It is clear that those suggested that nowadays some mental health challenges
employed in competitive workplaces such as health- might be recognized due to this synthesis and the po-
care environment, where there is a culture of working tential "ways" of their management offered. Additionally,
longer hours with less human and materials resources some individuals may find it useful to prevent MD and fa-
has negatively impacted on practitioners' emotional and cilitate social integration, better quality of life; reduce the
mental health(68). Furthermore, decreased productivity, morbidity and mortality of cancer, heart diseases, diabe-
defensiveness, protracted stress, and burnout now typify tes mellitus and AIDS patients. Finally, researchers can
workplaces where there is ongoing change and pres- obtain valuable and additional arguments through such
sure exerted on employees to continually excel(48, 53, 68-70). exchange of ideas presented across studies that may be
Therefore, qigong and yoga and the essence of these united by shared assumptions.
modalities could result in a minimized burnout, stress,
anxiety or depression and lead to an increased sense of Future Research
control over one's own holistic health. The authors are aware that to their best knowledge,
there is no research conducted in this filed confirming
Conclusion that the increased sense of control as the essence of
Within the scope of this article the authors' intention qigong and yoga exercises is a useful way in the psycho-
was to indicate the potential benefits of the therapeutic logical prevention of mental health disorders. However,
modalities, qigong and yoga for the psychological pre- first of all, the authors are tending to argue that minimiza-
vention of MD. Furthermore, such therapeutic interven- tion of MD's symptoms and risks is definitely possible and
tions have the potential to influence mental well-being, prevention may also occur—so take it like a continuum
quality of life and general/holistic health. It has been sug- in approach. Secondly, this is a conceptual level. The
gested that the sense of control over the body's move- authors have built such a concept/hypothesis and sug-
ments and postures as well as cognitive processes, emo- gest future research directions, as this would allow better
tional reactions, and behavioural patterns is the essence assess and understand the effects of "extracting" and
and the interface of both qigong and yoga. This sense adding qigong and/or yoga's essence into an integrated,
of control allows an individual to manage their mental multifaceted health promotion/prevention/development
health more efficiently in the sense that negative mental programs. Furthermore, the transmission of affect would
states and thoughts, emotions, moods could be recog- be worth investigating with regard to increased sense
nized and controlled when they occur and MD equally of control. Specifically, health care education specialists
prevented due to qigong and yoga. From the psychologi- could learn how to transmit the increased sense of con-
cal perspective it has been strongly argued that mental trol over their students. Subsequently, the teachers may
health disruptions such as depression, stress or anxiety encourage their students to transmit this notion to their
could be prevented and in the first instance at least mini- future patients(71). In conclusion the next article will reflect
mized. Both qigong and yoga exercises may facilitate on the transmission of increased sense of control in edu-
overall relaxation, improve concentration, and promote cational and healthcare settings.
meditation techniques. Both may also enhance the intel-
ligence, creative processes, thinking, memory, emotional REFERENCES
states and other brain activities. Considering all the pre- 1. World Health Organization. Mental health: new
sented arguments, it can be suggested that the essence understanding, new hope. Geneva: WHO; 2001.
of qigong and/or yoga exercises could be implemented 2. Shanley E. Common experiences of mental health nurses
into health psychology courses, or wider clinical practice. and consumers: ingredients of a symbiotic relationship?
Furthermore, patients or health care professionals could Aust N Z J Ment Health Nurs 2001;10:243-251.
become aware of their potential benefits for the preven- 3. Delaney KR. Inpatient psychiatric treatment: should
tion of stress, anxiety or depression and development of we revive a shrinking system? Arch Psychiatr Nurs
mental well-being. A discussion in the area of prevention 2006;20:242-244.
of mental health disorders and development of positive 4. Edwards D, Burnard P. A systematic review of stress and
health resources should be open and further explorations stress management interventions for mental health nurses.
Chin J Integr Med 2010 Feb;16(1):80-86 • 85 •

J Adv Nurs 2003;42:169-200. distress in tsunami survivors in the andaman islands. Evid
5. Hayman-White K, Happell B. Psychiatric nursing and Based Complement Alternat Med 2007;4:503-509.
mental health funding: the double dilemma. Int J Psychiatr 23. Brown RP, Gerbarg PL. Sudarshan Kriya Yogic breathing
Nurs Res 2007;12:1488-1496. in the treatment of stress, anxiety, and depression. Part
6. Littlejohn C. Critical realism and psychiatric nursing: a Ⅱ-clinical applications and guidelines. J Altern Comple-
philosophical inquiry. J Adv Nurs 2003;43:449-456. ment Med 2005;11:711-717.
7. Snow T. Too few to care. Nurs Stand 2004;18:12-13. 24. Nespor K. Physical exercise and yoga in prevention
8. Soltis-Jarrett V. Interactionality: willfully extending the and treatment of addictive diseases. Cas Lek Cesk
boundaries of participatory research in psychiatric-mental 2005;144:53-55.
health nursing. ANS Adv Nurs Sci 2004;27:316-329. 25. Sharma K, Shukla V. Rehabilitation of drug-addicted per-
9. World Health Organization. Mental health determinants and sons: the experience of the Nav-Chetna Center in India.
populations: department of mental health and substance Bull Narc 1988;40:43-49.
dependence. Geneva: WHO; 2000. 26. Lavey R, Sherman T, Mueser KT, Osborne DD, Currier M,
10. Kulmatycki L. Yoga for health. Warsaw: Book and Knowl- Wolfe R. The effects of yoga on mood in psychiatric inpa-
edge Publishing;1997. tients. Psychiatr Rehabil J 2005;28:399-402.
11. Kirkwood G, Rampes H, Tuffrey V, Richardson J, Pilkington 27. Gimbel MA. Yoga, meditation, and imagery: clinical applica-
K. Yoga for anxiety: a systematic review of the research tions. Nurse Pract Forum 1998;9:243-255.
evidence. Br J Sports Med 2005;39:884-891; discussion 91. 28. Waelde LC, Thompson L, Gallagher-Thompson D. A pilot
12. Malathi A, Damodaran A. Stress due to exams in medi- study of a yoga and meditation intervention for dementia
cal students-role of yoga. Indian J Physiol Pharmacol caregiver stress. J Clin Psychol 2004;60:677-687.
1999;43:218-224. 29. Moadel AB, Shah C, Wylie-Rosett J, Harris MS, Patel SR,
13. Shannahoff-Khalsa DS. Patient perspectives: Kundalini Hall CB, et al. Randomized controlled trial of yoga among
yoga meditation techniques for psycho-oncology and a multiethnic sample of breast cancer patients: effects on
as potential therapies for cancer. Integr Cancer Ther quality of life. J Clin Oncol 2007;25:4387-4395.
2005;4:87-100. 30. Sancier KM. Electrodermal measurements for monitoring
14. Sharma VK, Das S, Mondal S, Goswampi U, Gandhi A. Ef- the effects of a qigong workshop. J Altern Complement
fect of Sahaj yoga on depressive disorders. Indian J Physiol Med 2003;9:235-241.
Pharmacol 2005;49:462-468. 31. Litscher G, Wenzel G, Niederwieser G, Schwarz G. Effects
15. Woolery A, Myers H, Sternlieb B, Zeltzer L. A yoga inter- of qigong on brain function. Neurol Res 2001;23:501-505.
vention for young adults with elevated symptoms of depres- 32. Jones BM. Changes in cytokine production in healthy
sion. Altern Ther Health Med 2004;10:60-63. subjects practicing Guolin qigong: a pilot study. BMC
16. Yadav RK, Ray RB, Vempati R, Bijlani RL. Effect of a Complement Altern Med 2001;1:8.
comprehensive yoga-based lifestyle modification pro- 33. McCaffrey R, Fowler NL. Qigong practice: a pathway to
gram on lipid peroxidation. Indian J Physiol Pharmacol health and healing. Holist Nurs Pract 2003;17:110-116.
2005;49:358-362. 34. Xu SH. Psychophysiological reactions associated with
17. Kulmatycki L. Yoga Nidar. Warsaw: Book and Knowledge; qigong therapy. Chin Med J (Engl) 1994;107:230-233.
2004. 35. Agishi T. Effects of the external qigong on symptoms
18. Nayak NN, Shankar K. Yoga: a therapeutic approach. Phys of arteriosclerotic obstruction in the lower extremities
Med Rehabil Clin N Am 2004;15:783-798, vi. evaluated by modern medical technology. Artif Organs
19. Smith C, Hancock H, Blake-Mortimer J, Eckert K. A ran- 1998;22:707-710.
domised comparative trial of yoga and relaxation to reduce 36. Jung MJ, Shin BC, Kim YS, Shin YI, Lee MS. Is there any
stress and anxiety. Complement Ther Med 2007;15:77-83. difference in the effects of qi therapy (external Qigong)
20. Shannahoff-Khalsa DS. An introduction to Kundalini with and without touching? A pilot study. Int J Neurosci
yoga meditation techniques that are specific for the treat- 2006;116:1055-1064.
ment of psychiatric disorders. J Altern Complement Med 37. Lee MS, Kim MK, Lee YH. Effects of Qi-therapy (external
2004;10:91-101. qigong) on cardiac autonomic tone: a randomized placebo
21. West J, Otte C, Geher K, Johnson J, Mohr DC. Effects of controlled study. Int J Neurosci 2005;115:1345-1350.
Hatha yoga and African dance on perceived stress, affect, 38. Tsang HW, Cheung L, Lak DC. Qigong as a psychosocial
and salivary cortisol. Ann Behav Med 2004 ;28:114-118. intervention for depressed elderly with chronic physical
22. Telles S, Naveen KV, Dash M. Yoga reduces symptoms of illnesses. Int J Geriatr Psychiatry 2002;17:1146-1154.
• 86 • Chin J Integr Med 2010 Feb;16(1):80-86

39. Tsang HW, Fung KM, Chan AS, Lee G, Chan F. Effect of a 2006;13:27-32.
qigong exercise programme on elderly with depression. Int 54. Schnurr PP, Green BL. Understanding relationships among
J Geriatr Psychiatry 2006;21:890-897. trauma, post-tramatic stress disorder, and health outcomes.
40. Lee MS, Lim HJ. Impact of qigong exercise on self- Adv Mind Body Med 2004;20:18-29.
efficacy and other cognitive perceptual variables in patients 55. Selye H. The stress of life. New York: McGraw-Hill; 1956.
with essential hypertension. J Altern Complement Med 56. Papalia DE, Olds SW. Psychology. New York: McGraw Hill,
2004;10:675-680. London; 1988.
41. Siu JY, Sung HC, Lee WL. Qigong practice among 57. Spielberger CD. Anxiety and behavior. New York: Academ-
chronically ill patients during the SARS outbreak. J Clin ic Press Inc; 1966.
Nurs 2007;16:769-776. 58. Gross RD. The science of mind and behaviour: London:
42. Chow YW, Tsang HW. Biopsychosocial effects of Hodder Headline; 2001.
qigong as a mindful exercise for people with anxiety 59. Halperin S, Nathan P, Drummond P, Castle D. A cognitive-
disorders: a speculative review. J Altern Complement Med behavioural, group-based intervention for social anxiety in
2007;13:831-839. schizophrenia. Aust N Z J Psychiatry 2000;34:809-813.
43. Wu WH, Bandilla E, Ciccone DS, Yang J, Cheng SC, 60. Malim T, Birch A. Introductory psychology. Basingstoke:
Carner N, et al. Effects of qigong on late-stage complex Macmillan; 1998.
regional pain syndrome. Altern Ther Health Med 61. Barlow DH, Durand VM. Abnormal psychology. 4th ed. Aus-
1999;5:45-54. tralia: Thomson Wadsworth; 2005.
44. Ryu H, Lee HS, Shin YS, Chung SM, Lee MS, Kim HM, et 62. Gross RD, McIlveen R. Psychology: a new introduction.
al. Acute effect of qigong training on stress hormonal levels London: Hodder & Stoughton; 1998.
in man. Am J Chin Med 1996;24:193-198. 63. Cumbie SA. The integration of mind-body-soul and
45. Pan W, Zhang L, Xia Y. The difference in EEG theta waves the practice of humanistic nursing. Holist Nurs Pract
between concentrative and non-concentrative qigong 2001;15:56-62.
states—a power spectrum and topographic mapping study. 64. Potter PJ, Frisch N. Holistic assessment and care: pres-
J Tradit Chin Med 1994;14:212-218. ence in the process. Nurs Clin North Am 2007;42:213-228,
46. Sancier KM. Therapeutic benefits of qigong exercises vi.
in combination with drugs. J Altern Complement Med 65. Shanahan M. Holistic nursing theory: connecting heart &
1999;5:383-389. mind in practice. Beginnings 2005;25:1, 12-13.
47. Li M, Chen K, Mo Z. Use of qigong therapy in the 66. Smith KL. Appreciation of holistic nursing. J Holist Nurs
detoxification of heroin addicts. Altern Ther Health Med 2006;24:139.
2002;8:50-54, 56-59. 67. Tucakovic M. Working with the notion of soul in nursing.
48. Blonna R. Coping with stress in a changing world. 3rd ed. Aust J Holist Nurs 1999;6:39-41.
New York: McGraw Hill; 2005. 68. Glas N. Investing women nurse academics' experiences in
49. Sher KJ, Trull T. Psychological disorders: description, universities: the importance of hope, optimism and career
epidemiology, etiology and prevention. Pawlik K Rosen- resilience for workplace satisfaction. Annul Rev Nurs Educ
zwieg ed. International handbook of psychology. London: 2007;5:111-136.
Sage; 2000. 69. Gowing MK, Kraft JD, Quick JC. The new organizational
50. Lazarus RS, Folkman S. Stress, appraisal, and coping. reality: Downsizing, restructuring, revitalization. Washington
New York: Springer; 1984. DC: American Psychological Association; 1998.
51. Glass N, Rose J. Enhancing emotional well-being through 70. WFD C. When the going gets tough: Does your workforce
self-care: the experiences of community health nurses in have the resilience to keep going? It's about time, 11. 2004
Australia. Holist Nurs Pract 2008;22:336-347. [cited 2005 15th May]; Available from: http://www.wfd.com/
52. Papaghiuc C, Constantin B, Mihalache C, Oprea V, Carja E. news/past_news.html
Effects of psychological stress on health. Rev Med Chir Soc 71. Brennan T. The transmission of affect. Ithaca and London:
Med Nat Iasi 2005;109:705-708. Cornell University Press; 2004.
53. Rose J, Glass N. Community mental health nurses speak (Received October 10, 2008)
out: the critical relationship between emotional well- Edited by ZHANG Wen
being and satisfying professional practice. Collegian