® TOMATIS
Stress Rehabilitation Statistical Analysis First Presented at Château St Just, Paris 15 May 2016 Maria Moell Lundqvist Founder & Director Tomatis® New Zealand
The TomatisŽ Stress Rehabilitation Program was Financed by: Swedish Social Insurance Agency Alecta Occupational Insurance Participants’ Employers
Presentation Outline • • • • • •
Participants Tomatis® Intervention Measurements Results Control Group Conclusions
© Maria Moell Lundqvist, Tomatis® New Zealand
Participants • Client data:
98 (101) clients pre/post 81 (84) clients pre/post/follow-up
• Inclusion criteria:
All clients from 2003 to 2011 ≥ 20 Maastricht VE or ≥ 4.0 SMBQ
© Tomatis Nordiska AB
• M/F: 70% women, 30% men • Background: majority professionals with stable family situation
• Diagnoses: burnout, stress, insomnia, post traumatic stress disorder (PTSD), depression, stroke, whiplash, concussion, brain trauma © Maria Moell Lundqvist, Tomatis® New Zealand
Tomatis® Program • Listening program:
2, 3 or 4 intensive blocks of 30 hours listening training each
• Average length: 90 hours • Voice: 30% of clients
also did active voice work
• Total program duration: 6 months • Follow-up: After 6 months
© Maria Moell Lundqvist, Tomatis® New Zealand
Questionnaires Used Initial assessment
30 h
30 h
30 h
6 months’ follow-up
1. Karolinska Sleep Questionnaire 2. Shirom-Melamed Burnout Questionnaire 3. Maastricht Vital Exhaustion Index These are standardized questionnaires extensively used in research.
© Maria Moell Lundqvist, Tomatis® New Zealand
Karolinska Sleep Questionnaire KSQ measures sleep quality, awakening, and tiredness during the day • 11 questions, range from 1=”Never” to 6=”Always” • Sub-scales: Sleep Quality, Awakening, Tiredness • Calculate average score for each sub-scale Do you have difficulties falling asleep? Do you wake up too early?
1 2 3 4 5 6 1 2 3 4 5 6
© Maria Moell Lundqvist, Tomatis® New Zealand
Karolinska Sleep Questionnaire Mean Values
Š Maria Moell Lundqvist, TomatisŽ New Zealand
Karolinska Sleep Questionnaire Basic Statistics (Statistica Software)
T-test for Dependent Samples. Marked differences are significant at
p < .00001 Mean
Std.Dv.
KSQ Sleep Quality Before Tomatis
3.798016
1.085350
KSQ Sleep Quality After Program
2.841837
1.061503
KSQ Sleep Quality Before Tomatis
3.829698
1.100644
KSQ Sleep Quality 6 Months’ Follow-up
2.882716
1.079704
N
Diff.
98
0.956179
81
0.946982
Std.Dv. Diff.
t
df
p
0.972632
9.732034
97
0.000000
0.860244
9.907465
80
0.000000
© Maria Moell Lundqvist, Tomatis® New Zealand
Karolinska Sleep Questionnaire Box & Whisker Plot – Sleep Quality Index Mean, Mean±SE, Mean±SD Box & Whisker Plot - Karolinska Sleep Questionnaire - Sleep Quality 6
5
4
3
2
1
Before Tomatis 6 month's follow-up
© Maria Moell Lundqvist, Tomatis® New Zealand
Mean Mean±SE Mean±SD
Shirom-Melamed Burnout Questionnaire SMBQ measures different factors of burnout syndrome • 22 questions, range from 1=”Never” to 7=”Always” • Sub-scales: Burnout, Listlessness, Tension, Cognitive Weariness, Global (=all questions) • Calculate average score for each sub-scale I feel physically drained
1 2 3 4 5 6 7
I have difficulty concentrating
1 2 3 4 5 6 7
My thinking process is slow
1 2 3 4 5 6 7
© Maria Moell Lundqvist, Tomatis® New Zealand
Shirom Melamed Burnout Questionnaire Mean Values Before Tomatis After program
7
6 months' follow-up
6 5 4 3 2 1
Burnout
Listlessness
Tension
Cognitive Weariness
Š Maria Moell Lundqvist, TomatisŽ New Zealand
Global
Shirom Melamed Burnout Questionnaire Basic Statistics (Statistica Software) T-test for Dependent Samples. Marked differences are significant at
p < .00001 Mean
Std.Dv.
SMBQ Global Before Tomatis
5.063823
0.773305
SMBQ Global After Program
3.151522
1.153174
SMBQ Global Before Tomatis
5.063148
0.751942
SMBQ Global 6 Months’ Follow-up
2.898681
1.017667
N
Diff.
100
1.912301
84
2.164467
Std.Dv. Diff.
t
df
p
0.981573
19.48201
99
0.000000
0.964159
20.57511
83
0.000000
© Maria Moell Lundqvist, Tomatis® New Zealand
Shirom Melamed Burnout Questionnaire Box & Whisker Plot – Global Index Mean, Mean±SE, Mean±SD Box & Whisker Plot - Shirom Melamed Burnout Questionnarie - Global Index 7
6
5
4
3
2
1
Before Tomatis 6 months' follow-up
© Maria Moell Lundqvist, Tomatis® New Zealand
Mean Mean±SE Mean±SD
Maastricht Vital Exhaustion Index VE measures ”life exhaustion”, a marker of longstanding stress characterized by excessive fatigue, lack of energy, increased irritability, demoralization and depression • 23 questions: ”Yes”=2, ”No”=0, ”Don´t know”=1 Do you often feel tired?
Yes No Don’t know
Do you feel you want to give up trying?
Yes No Don’t know
Do little things irritate you more than they used to?
Yes No Don’t know
© Maria Moell Lundqvist, Tomatis® New Zealand
Maastricht Vital Exhaustion Index Mean Values
© Maria Moell Lundqvist, Tomatis® New Zealand
Maastricht Vital Exhaustion Index Basic Statistics (Statistica Software)
T-test for Dependent Samples. Marked differences are significant at
p < .00001 Mean
Std.Dv.
VE Before Tomatis
32.02970
7.767182
VE After Program
13.73267
9.789679
VE Before Tomatis
32.28916
7.962611
VE 6 Months’ Follow-up
11.72289
8.819758
N
Diff.
101
18.29703
83
20.56627
Std.Dv. Diff.
t
df
p
9.508464
19.33886
100
0.000000
9.936620
18.85627
82
0.000000
© Maria Moell Lundqvist, Tomatis® New Zealand
Maastricht Vital Exhaustion Index Box & Whisker Plot Mean, Mean±SE, Mean±SD Box & Whisker Plot - Maastricht Vital Exhaustion Index 45 40 35 30 25 20 15 10 5 0
Before Tomatis 6 months' follow-up
© Maria Moell Lundqvist, Tomatis® New Zealand
Mean Mean±SE Mean±SD
Maastricht Vital Exhaustion Index Development During the Tomatis® Program
© Maria Moell Lundqvist, Tomatis® New Zealand
Maastricht Vital Exhaustion Index Before and 6 monthsâ&#x20AC;&#x2122; Follow-up, All Clients
Return to Work
Š Maria Moell Lundqvist, TomatisŽ New Zealand
Comparison Group
Other Intervention • • • • • •
Well-known stress rehabilitation clinic Structured intervention program 40 participants, 70% women 6 months’ duration KSQ, SMBQ and VE before, after program & 6 months follow-up Participants referred by the same insurance companies © Maria Moell Lundqvist, Tomatis® New Zealand
KSQ – Tomatis® vs Control Tomatis®
Other intervention
6
6
5
5
4
4
3
3
2
2
1
Sleep Quality
Awakening
p<0.00001
Tiredness
1
Sleep Quality
ns
Awakening
Tiredness
p<0.05
p<0.001
© Maria Moell Lundqvist, Tomatis® New Zealand
SMBQ – Tomatis® vs Control 7
Tomatis® 7
6
6
5
5
4
4
3
3
2
2
1
1
Other intervention
p<0.00001
© Maria Moell Lundqvist, Tomatis® New Zealand
p<0.001
Vital Exhaustion – Tomatis® vs Control Other intervention
Tomatis® 45
45
40
40
35
35
30
30
25
25
20
20
15
15
10
10
5
5
0
0
p<0.00001
p<0.001
© Maria Moell Lundqvist, Tomatis® New Zealand
Return to Work – Tomatis® vs Control Tomatis®
Other intervention
© Maria Moell Lundqvist, Tomatis® New Zealand
Conclusions 1. KSQ, SMBQ and VE clearly demonstrate the effectiveness of the Tomatis® Rehabilitation Program 2. VE is a good predictor of program length: 3 x VE ≈ No of Tomatis® hours 3. VE reacts very fast (20 hours), SMBQ takes a little longer, KSQ a few months 4. Tomatis® Level 1 programs go a long way 5. Add Tomatis® Active Voice work if possible 6. Trust statistics: Results reliable; data extremely robust
© Maria Moell Lundqvist, Tomatis® New Zealand
Swedish Team: Tomatis® Consultants Level 4
Helena BOWIN
Torbjörn FREIJ
Maria MOELL Ewa HERMANSSON LUNDQVIST
• Antonia JACOBAEUS, MD
© Maria Moell Lundqvist, Tomatis® New Zealand
Maria Moell Lundqvist • Master of Science in Engineering Physics and 18 years in global corporations • Introduced Tomatis® in Sweden • Founder and Director of Tomatis® Nordiska 1998 – 2012 • Awarded ”Business Owner of the Year” 2006 in Sollentuna/Stockholm • Tomatis® Consultant Level 4 and Tomatis® International Trainer • Introducing Tomatis® in New Zealand since 2012 © Maria Moell Lundqvist, Tomatis® New Zealand
Many thanks for making this study possible! The Participants, their Families, and Employers Swedish Social Insurance Agency Alecta Occupational Insurance Invaluable advice and support from researchers at Uppsala University and Karolinska Institute
Download a copy of the presentation and learn more about our work at
www.tomatis.co.nz/stress