Short-term Effects of Randomized Mindfulness-Based Intervention in Female Breast Cancer Survivors: A Systematic Review and Meta-analysis

Cancer Nurs. 2021 Nov-Dec 01;44(6):E703-E714.

Abstract

Background: Patients with breast cancer usually experience depression, anxiety, stress, fatigue, pain, poor sleep quality, and low quality of life after their cancer treatment. Some studies used mindfulness-based stress reduction (MBSR) interventions for reducing these symptoms; however, the results are conflicting.

Objective: This study evaluated the clinical efficacy of MBSR interventions in the short term.

Methods: Five databases were searched from their inception to April 2020. We included only randomized controlled trials (RCTs) comparing MBSR intervention and control groups for symptom reduction in women with breast cancer. Pooled mean difference (MD), standardized MD, and 95% confidence intervals (CIs) were calculated using random-effects models. We used the Cochrane risk-of-bias assessment tool to assess the included RCTs.

Results: Nineteen RCTs with 36 to 336 participants were included, of which 11 studies with a total of 1687 participants (mean age, 53.3 years) were eligible for the meta-analysis. The pooled meta-analysis results indicated that, at the end of the MBSR interventions, participants’ depression (standardized MD, -1.32; 95% CI, -2.18 to -0.46; I2 = 97%) and fatigue (MD, -0.47; 95% CI, -0.59 to -0.34; I2 = 0%) levels had significantly decreased; moreover, up to 3 months after baseline, their stress levels had significantly decreased (MD, -0.79; 95% CI, -1.34 to -0.24; I2 = 0%).

Conclusion: Mindfulness-based stress reduction interventions are highly beneficial for reducing depression, fatigue, and stress in the short term.

Implications for practice: Mindfulness-based stress reduction interventions are cost-effective and practical. Breast cancer survivors are recommended to practice MBSR as part of their daily care routine.

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Examination of the Effectiveness of Mindfulness-Based Cognitive Therapy on Patients with Obsessive-Compulsive Disorder: Systematic Review and Meta-Analysis

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Issues Ment Health Nurs. 2021 Nov;42(11):998-1009.

Abstract

This study conducted a meta-analysis to examine the effectiveness of mindfulness-based cognitive therapy in patients with an obsessive-compulsive disorder. A meta-analysis is able to evaluate scientifically evidence at the highest level. Studies conducted between 2008 and 2020 were accessed from PubMed, Web of Science, Scopus, Science Direct, and other databases for evaluation and possible inclusion. Mindfulness-based cognitive therapy was shown to have a moderate effect (standardized mean difference: 0.283), but this this was enough to indicate a significant reduction in obsessive-compulsive symptoms in the experimental groups compared to the control groups (p = .002).

Mindfulness-based cognitive therapy can be considered an effective approach for use with individuals with a diagnosis of obsessive-compulsive disorder.

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Mindfulness-based programs for the prevention of childhood obesity: A systematic review

Appetite. 2021 Oct 4;168:105725

Abstract

Introduction: The prevalence of overweight and obesity has increased worldwide at an alarming rate in recent decades and has become a serious public health problem. The purpose of this study is to carry out a systematic review of scientific research on mindfulness-based programs for the prevention of childhood obesity carried out in the last 10 years.

Method: A search of studies that used mindfulness to promote good eating behavior in minors was conducted. After applying the inclusion and exclusion criteria, a total of 16 studies were found.

Results: Statistically significant improvements were found in most of the cases where changes in eating habits, food portions, reduction of stress, or reduction of cravings in minors were evaluated.

Conclusions: Mindfulness programs applied to improve eating behaviors appear to be an effective alternative to prevent childhood obesity, but further studies are needed to draw conclusions.

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Mindfulness training for borderline personality disorder: A systematic review of contemporary literature

Personal Ment Health. 2021 Sep 22.

Abstract

Mindfulness is a component of several psychotherapies. Nonetheless, its effectiveness in borderline personality disorder (BPD) management remains obscure. This systematic review examined the effect of mindfulness training in BPD patients. Cochrane Central Register of Controlled Trials, CAB Abstracts, Embase, MEDLINE and APA PsycInfo were searched until 30 June 2021. Five trials with 294 participants were included. Improvements were reported in participants’ levels of impulsivity, in their emotion dysregulation patterns, in their attention skills and in their mindfulness-related capacities including decentering and nonjudging.

The findings suggest that mindfulness training may be an effective tool for alleviating certain aspects of BPD symptomatology. More research is needed before definitive conclusions can be reached about the effectiveness of mindfulness training in the treatment of BPD patients, and this remains to be elucidated in larger structured clinical trials, with longer follow-ups.

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Impacts of mindfulness-based interventions in people undergoing hemodialysis: a systematic review

Image: Wikimedia Commons

J Bras Nefrol. 2021 Oct 11;S0101-28002021005070301.

Abstract

Introduction: Chronic kidney disease (CKD) is a serious public health problem worldwide, leading to a series of physical and psychological comorbidities, in addition to costly treatments, lifestyle and dietary restrictions. There is evidence that mindfulness-based interventions (MBIs) offer complementary treatment for people with chronic illnesses, including CKD, with the aim of improving overall health, reducing side effects and treatment costs. This review aims to investigate the MBIs impact on people with CKD undergoing hemodialysis, and to identify the methodological quality of the current literature in order to support future studies.

Methods: We ran searches in five databases (MEDLINE via PubMed, PsycINFO, Embase, Web of Science and Scopus) in July 2020. The papers were selected and evaluated by two reviewers independently, using predefined criteria, including the Cochrane Group’s risk of bias tool and its recommendations (CRD42020192936).

Results: Of the 175 studies found, 6 randomized controlled trials met the inclusion criteria, and ranged from 2014 to 2019. There were significant improvements in symptoms of anxiety, depression, self-efficacy, sleep quality, and quality of life (n=3) in the groups submitted to the intervention, in addition to physical measures such as blood pressure, heart rate and respiratory rate (n=1).

Conclusions: MBIs can offer a promising and safe complementary therapy for people with CKD undergoing hemodialysis, acting on quality of life and physical aspects of the disease.

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Staff psychological support response to COVID-19

How the Lancashire Teaching Hospitals NHS Trust has implemented a psychological support service for its staff.

Overview

At the start of the COVID-19 pandemic, Lancashire Teaching Hospitals Trust (LTHTR) recognised that more staff would need to access psychology services. Almost 1000 staff have been able to access psychological support since adopting new pathways as part of their overall health and wellbeing offer.

Key benefits and outcomes

A number of key steps were taken, including:

• development and delivery of a staff support helpline
• provision of individual therapy for identified staff
• provision of tailored group support to specific staff groups
• delivery of mindfulness based cognitive therapy to support mental wellbeing and resilience.

What the organisation faced

LTHTR had already made a commitment to support staff psychological wellbeing prior to the pandemic, with the provision of mindfulness sessions and courses since 2016, and individual therapy with a clinical psychologist since 2017.  Additional investment for a cognitive behavioural therapist was established in 2019 to expand the provision of one-to-one and group therapy.

The incident support service was established in 2017/18 with a remit to support staff who had experienced distressing incidents at work through group and one-to-one sessions.

Early on in the pandemic, many staff groups and wards in the hospital were identified as requiring additional support to manage psychological wellbeing. This was delivered by staff from the health and wellbeing team, with strong support from other teams, building on the existing psychological wellbeing services. 

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Further information

For further information on this case study please contact:

Ruth Lawrence, CBT Therapist, Psychological Wellbeing Service.

Ruth.lawrence@lthtr.nhs.uk

Liz Tallentire, Clinical Psychologist, Psychological Wellbeing Service

Elizabeth.tallentire@lthtr.nhs.uk