Effects of a Mindfulness Intervention on Hospitalized Patients With Hematologic Malignancies and Their Caregivers

App-Based Mindfulness Intervention to Improve Psychological Outcomes in Pretransplant Patients With Heart Failure

Background

Patients hospitalized with life-threatening conditions experience psychological stressors that can lead to anxiety and poor patient outcomes. Mindfulness stress reduction interventions have been shown to decrease stress and anxiety with sustained effect.

Local Problem

In a single center’s cardiac care units, only pharmacological stress reduction options were embedded in the daily care plan.

Methods

This project evaluated the feasibility and effect of a brief mindfulness intervention on stress, anxiety, and resilience in 20 hospitalized patients with advanced heart failure awaiting transplant. A 1-group, pretest-posttest design over a 4-week period was used. The intervention included a one-on-one mindfulness education session and a 12-minute audio-guided tablet computer app for daily self-practice. Outcome variables measured at baseline and 2 and 4 weeks after implementation included stress (10-item Perceived Stress Scale), anxiety (7-item Generalized Anxiety Disorder instrument), and resilience (10-item Connor-Davidson Resilience Scale). Statistical analysis included descriptive statistics and repeated-measures analysis of variance with Friedman tests, Bonferroni post hoc tests, and Wilcoxon matched-pairs tests.

Results

Significant reductions in stress and anxiety and increase in resilience occurred from baseline to 2 weeks and 4 weeks after intervention (all P = .001). Feasibility and acceptability were evident from patient experience survey data and focused interview responses.

Conclusions

A brief mindfulness intervention holds promise for improving stress, anxiety, and resilience for patients with advanced heart failure awaiting transplant. Nurse-led stress reduction interventions are imperative for best patient outcomes. An evidence-based intervention of mindfulness practice embedded into daily usual patient care may be a feasible option.

International PRISMA scoping review to understand mental health interventions for depression in COVID-19 patients

Preliminary research indicates that the COVID-19 illness affects the mental well-being of patients. This scoping review, thus, aims to examine the current state of research into mental health treatments for depression symptoms in COVID-19 patients. Select databases were searched on 7/1/2021. Full-text articles involved (1) mental health treatment (2) suicide and/or depression outcomes, (3) a quasi-experimental research trial, and (4) a primary analysis. 11 articles were included in this review. The studies spanned 5 countries, and demonstrated immediate positive effects of mental health treatments and tele-health as a treatment modality for depression in COVID-19 patients. 6 studies were randomized controlled trials. Various treatments were administered, including cognitive behavior therapy, mindfulness, and muscle relaxation. Most interventions were conducted in in-patient units and focused on acute symptoms. There were limitations in the design and description of methodology in many studies, which affects the generalizability and replicability of positive findings. Only two studies included a post-intervention follow-up and one study assessed suicide risk. Thus, this review found there is a pressing need for more research in the area, with greater rigor in study methodology, and for treatments targeting long-term symptoms and suicidality, and outpatient services.

Mindfulness in Adolescent and Young Adult (AYA) Patients Undergoing Hematopoietic Stem Cell Transplantation (HSCT): A Qualitative Study

Simple Summary

Previous research in adolescent and young adult (AYA) patients suggests that patients undergoing hematopoietic stem cell transplantation (HSCT) experience severe physiological stress and social challenges. Therapeutic mindfulness interventions have been associated with improved well-being; however, we are unaware of any study that has examined AYA HSCT patients’ therapeutic interests in improving quality of life. The goal of this study was to identify unmet needs, interests, and preferences for mindfulness and quality of life prior to, immediately following, and three months post HSCT to inform the development of a mindfulness-based stress reduction intervention. Results suggest a mindfulness-based intervention may be beneficial in improving quality of life and enhancing social engagement, particularly immediately following HSCT. Future AYA research may benefit from employing mindfulness-based techniques to improve quality of life and psychosocial outcomes in HSCT patients.

Abstract

Previous adolescent and young adult (AYA) research suggests patients undergoing hematopoietic stem cell transplantation (HSCT) experience severe physiological stress. The goal of this study was to identify unmet needs, interests, and preferences for mindfulness to inform the development of a mindfulness-based stress reduction intervention. Semi-structured interviews were conducted at three time points: prior to (n = 20), immediately after (n = 13), and three months post HSCT (n = 16) in the same AYA patients. Interviews assessed stress reduction strategies used, interest in mindfulness, and current quality of life. Three major thematic categories emerged from interview data across all time points: Concerns, Coping Strategies, and Mindfulness Activities. Prior to HSCT, two additional themes emerged including: Hope for the Future and Getting the Body Moving-Physical Activity. Most participants were not familiar with the term “mindfulness” prior to HSCT; but after being provided the definition of mindfulness, participants expressed interest in an online mindfulness-based intervention (e.g., ZOOM), stating: “I think it’s necessary” and “It would definitely be useful”. Participants suggested an intervention immediately following HSCT may decrease isolation concerns stating: “[in the hospital] You kind of feel like a hamster in a cage” and “you obviously have a lot of time to just be sitting by yourself in a hospital room”. The results suggest that a mindfulness-based online intervention is of interest to AYA HSCT patients and may be beneficial in decreasing physiological stress and improving quality of life.