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The Effect of Mindfulness in Inflammation Markers (MLR, NLR, PLR), Stress, Anxiety, and Depression Rate Among Survivors of Tidal Flooding in Sayung Demak

27 augusti 2026 uppdaterad av: Natalia Dewi Wardani, MD

Tidal flood disasters in coastal areas cause chronic psychological stress due to economic, social, and residential disruption. Psychological stress is closely linked to systemic inflammatory responses-marked by elevated Monocyte-to-Lymphocyte Ratio (MLR), Neutrophil-to-Lymphocyte Ratio (NLR), and Platelet-to-Lymphocyte Ratio (PLR)-which are associated with depression and anxiety symptoms. Mindfulness interventions, particularly body scan techniques, have been shown to reduce psychological distress and modulate immune responses, but empirical evidence on coastal flood survivors in Indonesia remains limited.

This study aims to evaluate the effectiveness of a community-based mindfulness body scan intervention on inflammatory biomarkers (MLR, NLR, PLR) and psychological parameters (stress, depression, anxiety, trauma, sleep quality, and resilience) among tidal flood survivors in Sayung, Demak. Participants will undergo baseline blood work and psychometric assessments, receive an 8-day mindfulness body scan intervention, and complete post-intervention evaluations.

Studieöversikt

Status

Har inte rekryterat ännu

Betingelser

Intervention / Behandling

Detaljerad beskrivning

Background:

Coastal communities in Sayung District, Demak Regency, face recurrent tidal flooding (rob) that causes continuous environmental and economic pressure. From a psychoneuroimmunological perspective, chronic psychosocial stress triggers systemic low-grade inflammation. Biomarkers such as MLR, NLR, and PLR serve as accessible systemic inflammatory indices that correlate with mood disorders and stress severity. Mindfulness body scan training aims to improve interoceptive awareness, emotional regulation, and parasympathetic activity, thereby reducing stress reactivity and systemic inflammation.

Study Design and Objectives:

This is an interventional pre-post experimental study conducted at the Sayung 1 Public Health Center (Puskesmas Sayung 1), Demak. The study evaluates changes in systemic inflammatory markers and psychological parameters pre- and post-intervention.

Intervention:

Participants will participate in a structured mindfulness body scan program over an 8-day period. The body scan protocol guides participants to direct attention sequentially to various body regions without judgment to enhance somatic awareness and stress mitigation.

Assessments:

  1. Laboratory Testing: Complete blood counts to determine monocyte, neutrophil, platelet, and lymphocyte ratios (MLR, NLR, PLR) pre- and post-intervention.

  2. Psychometric Evaluations: Assessment of psychological symptoms using validated tools, including:

    • Beck Depression Inventory (BDI) & Patient Health Questionnaire-9 (PHQ-9)
    • Depression, Anxiety, and Stress Scale-21 (DASS-21)
    • Impact of Event Scale - Revised (IES-R) & PTSD Checklist-5 (PCL-5)
    • Pittsburgh Sleep Quality Index (PSQI)
    • Connor-Davidson Resilience Scale (CD-RISC)
    • Spiritual Wellbeing Scale (SWBS)
    • Fatigue Assessment Scale (FAS)
    • WHO Quality of Life (WHOQOL)
    • Perceived Social Performance (PSP)

Data Analysis:

Pre- and post-intervention data will be analyzed using paired statistical tests and multivariate regression to determine changes in inflammatory markers and psychological scores, as well as the correlation between systemic inflammation changes and psychological recovery.

Studietyp

Interventionell

Inskrivning (Beräknad)

70

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studiekontakt

  • Namn: Natalia Dewi Wardani Dr. dr. Sp.KJ(K)
  • Telefonnummer: +6281325683134
  • E-post: anatdew@gmail.com

Studieorter

  • Indonesien
    • Central Java
      • Demak, Central Java, Indonesien
        • Puskesmas Sayung 1

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

  • Vuxen

Tar emot friska volontärer

Ja

Beskrivning

Inclusion Criteria:

  • Adults aged 18 to 60 years.
  • Survivors of tidal flooding (bencana rob) residing in the Sayung coastal area for at least 6 months.
  • Minimum educational attainment of Primary School (Sekolah Dasar / SD).
  • Literate in Indonesian (able to read and write).
  • Willing to participate in and complete the 8-day mindfulness intervention program.
  • Physically independent and capable of completing self-administered questionnaires.

Exclusion Criteria:

  • Active psychotic disorders or severe mental illness.
  • Cognitive impairment that limits ability to complete assessments.
  • History of diagnosed autoimmune disorders, active allergies, or chronic inflammatory diseases.
  • Presence of acute infectious disease symptoms within the past 1 month.
  • Currently undergoing formal psychotherapy or other structured psychological interventions.

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: N/A
  • Interventionsmodell: Enskild gruppuppgift
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: Mindfulness Body Scan Group
Participants in this single arm receive an 8-day community-based mindfulness body scan training designed to evaluate its effects on systemic inflammatory markers (MLR, NLR, PLR) and psychological parameters.
Beteende: Mindfulness Body Scan
A structured 8-day behavioral intervention consisting of guided mindfulness body scan practices. Participants are instructed to direct non-judgmental attention sequentially across different regions of the body to enhance somatic awareness, promote relaxation, and reduce psychological stress reactivity.

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Change in Monocyte-to-Lymphocyte Ratio (MLR)
Tidsram: Baseline and Day 8 (post-intervention)
Changes in MLR derived from routine complete blood count to evaluate systemic inflammation.
Baseline and Day 8 (post-intervention)
Change in Neutrophil-to-Lymphocyte Ratio (NLR)
Tidsram: Baseline and Day 8 (post-intervention)
Changes in NLR derived from routine complete blood count to evaluate systemic inflammation
Baseline and Day 8 (post-intervention)
Change in Platelet-to-Lymphocyte Ratio (PLR)
Tidsram: Baseline and Day 8 (post-intervention)
Changes in PLR derived from routine complete blood count to evaluate systemic inflammation.
Baseline and Day 8 (post-intervention)
Change in DASS-21 Score
Tidsram: Baseline and Day 8 (post-intervention)
Evaluation of changes in psychological distress using the Depression, Anxiety, and Stress Scale-21 (DASS-21). Total score ranges from 0 to 63, where higher scores indicate higher levels of psychological distress.
Baseline and Day 8 (post-intervention)
Change in Beck Depression Inventory (BDI) Score
Tidsram: Baseline and Day 8 (post-intervention)
Evaluation of changes in depressive symptoms using the BDI questionnaire. Total score ranges from 0 to 63, where higher scores indicate more severe depression.
Baseline and Day 8 (post-intervention)
Change in Patient Health Questionnaire-9 (PHQ-9) Score
Tidsram: Baseline and Day 8 (post-intervention)
Evaluation of depression severity using the PHQ-9 scale. Total score ranges from 0 to 27, where higher scores indicate more severe depressive symptoms.
Baseline and Day 8 (post-intervention)

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Change in Pittsburgh Sleep Quality Index (PSQI) Score
Tidsram: Baseline and Day 8 (post-intervention)
Evaluation of sleep quality using the PSQI questionnaire. Total score ranges from 0 to 21, where higher scores indicate poorer sleep quality.
Baseline and Day 8 (post-intervention)
Change in Connor-Davidson Resilience Scale (CD-RISC) Score
Tidsram: Baseline and Day 8 (post-intervention)
Evaluation of psychological resilience levels using the CD-RISC questionnaire. Total score ranges from 0 to 100, where higher scores indicate greater resilience.
Baseline and Day 8 (post-intervention)
Change in Impact of Event Scale-Revised (IES-R) Score
Tidsram: Baseline and Day 8 (post-intervention)
Evaluation of post-traumatic stress distress related to the tidal flood disaster using the IES-R. Total score ranges from 0 to 88, where higher scores indicate greater post-traumatic distress.
Baseline and Day 8 (post-intervention)
Change in WHOQOL-BREF Score
Tidsram: Baseline and Day 8 (post-intervention)
Evaluation of quality of life across physical, psychological, social, and environmental domains using the WHOQOL-BREF scale. Domain scores are transformed to a scale of 0 to 100, where higher scores indicate higher quality of life.
Baseline and Day 8 (post-intervention)

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Natalia Dewi Wardani, MD

Publikationer och användbara länkar

Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.

Allmänna publikationer

  • Kabat-Zinn J. Full catastrophe living: using the wisdom of your body and mind to face stress, pain, and illness. New York: Dell Publishing; 2013.

Användbara länkar

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Beräknad)

1 september 2026

Primärt slutförande (Beräknad)

1 februari 2027

Avslutad studie (Beräknad)

1 april 2027

Studieregistreringsdatum

Först inskickad

27 augusti 2026

Först inskickad som uppfyllde QC-kriterierna

27 augusti 2026

Första postat (Faktisk)

1 september 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

1 september 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

27 augusti 2026

Senast verifierad

1 augusti 2026

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • FK-UNDIP-MIND-02

Plan för individuella deltagardata (IPD)

Planerar du att dela individuella deltagardata (IPD)?

NEJ

IPD-planbeskrivning

The data are not publicly available due to privacy or ethical restrictions. The dataset involves sensitive information about mental health, and sharing it publicly would compromise participant confidentiality as per the ethical approval obtained.

Läkemedels- och apparatinformation, studiedokument

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