P0602 - Mindfulness Meditation for Hospitalized Pediatric Patients: A Pilot Study

Background:
Hospitalized pediatric patients often suffer from acute pain and anxiety. Medications or distraction methods are frequently the first line therapeutics for such symptoms. Many studies have demonstrated the benefit of meditation for adult patients, however limited data exists regarding the role of meditation in hospitalized pediatric patients. We hypothesize that providers from various professional backgrounds can be trained to lead a bedside mindfulness meditation, which can be an effective and safe modality to decrease anxiety and pain in hospitalized pediatric patients.

Methods:
One nurse and one child life specialist completed three, 75-minute mindfulness meditation training sessions led by a volunteer certified meditation instructor. Then, over a 6-month period the providers identified pediatric patients suffering from pain and/or anxiety. IRB approval was attained through the University of California, Los Angeles (IRB#18-000891-AM-00001). A standard care protocol was implemented (Figure 1). After determining that a patient did not need immediate attention from the physician, the provider then led a bedside mindfulness meditation. A total of 11 patients (ten pediatric, and one adult on the pediatric floor) were identified as suitable for such an intervention, and its duration and type were determined by the provider. After each session, the nurse or child life specialist completed a qualitative survey describing their own experience, as well as the patient and/or parent(s)’ impressions. Their responses were analyzed to assess feasibility of this practice and inform future study.

Results
Data was collected on 11 patients, ages 10 to 16, with one 24 year-old. Diagnoses included malignancy, anorexia, abdominal pathology, and musculoskeletal disorders. The average length of the intervention was 26 minutes and was utilized in cases of pain, anxiety/panic attacks, as well as concurrent pain and anxiety. In 81% (9/11) of the cases, the provider observed that the patient’s pain and/or anxiety improved as a result of the meditation. In 45% (5/11) of cases, the provider observed that medication was likely avoided due to the guided meditation. After the three training sessions, the providers felt well-trained in performing the intervention, in 91% (10/11) of the encounters. Importantly, 87.5% of parents had a favorable impression of the intervention.

Conclusion
Training providers in bedside mindfulness meditation can be accomplished in three, 75-minute training sessions. Our limited data suggest that opiate/anxiolytic use could be significantly decreased with such an intervention. Additionally, parents had a favorable impression and there were no negative consequences or perceived harms. This is the first study of its kind providing qualitative information about an inpatient pediatric bedside mindfulness meditation. Training more providers and increasing the number of patients studied will yield greater insight into clinical implications of this promising intervention.