Brief Mindfulness Intervention Improves Pain and Psychological Wellbeing Post-Transplant or LVAD

Abstract:

Background: Patients receiving an organ transplant or left ventricular assist device (LVAD) are at risk for developing psychologically distressing symptoms after surgery, such as pain and stress. If left untreated, these symptoms may escalate to clinically significant depression and anxiety and thus negatively impacting surgical outcomes. Mindfulness-based interventions for transplant recipients improve psychological symptoms and wellbeing (Gross et al, 2004; Kreitzer et al, 2005, Stonnington et al, 2016). However, existing interventions are lengthy. The aim of this study was to design and implement a brief, one session mindfulness intervention and assess immediate impact.

Methods: Living organ donors and transplant/LVAD recipients from 12/2021-3/2022 were approached by the health psychology team while hospitalized during the immediate post-operative period, once medically stable, and were invited to participate in a brief mindfulness intervention. Prior to the intervention, patients rated their level of pain, stress, happiness, and overwhelmed feelings on a scale of 0-10 (10= greatest amount). Patients were then educated on mindfulness and practiced a brief mindfulness intervention that paired diaphragmatic breathing with guided imagery. After completing the intervention, patients were again asked to provide ratings of the same items.

Results: To date, 53 patients were approached post-transplant/LVAD (n= 49) or post-donation (n= 4). Of these 83.0% (n= 44) chose to engage in the brief intervention. Of those who participated, 79.5% (n=35) were transplant recipients, 11.4% (n=5) were LVAD recipients, and 9.1% (n=4) were living donors. Approximately half (52.3%, n= 23) were male, 65.9% (n= 29) were White, with a mean age of 52.14 years (SD= 11.99). From pre- to post-intervention, participants reported significant reductions in stress (t= 4.70, p< .001), pain severity (t= 4.80, p< .001), and feeling overwhelmed (t= 4.35, p< .001). Ratings of happiness increased from pre- to post-intervention (t= -2.70, p= .01).

Discussion: A brief mindfulness intervention may be effective in reducing psychological distress in patients after transplant-related/LVAD surgery. Psychological interventions in the post-operative period may serve to improve distress and mitigate risk of developing clinically significant depression and anxiety. Future research could evaluate this with a larger sample size, compare the intervention to a control group, and could examine whether there are sustained effects of the intervention.



References:

Gross, C., et al. (2004). Mindfulness Meditation to Reduce Symptoms After Organ Transplant: A Pilot Study. Alternative Therapies, 10(3), 58–66.

Kreitzer, et al. (2005). Longitudinal impact of mindfulness meditation on illness burden in solid-organ transplant recipients. Progress in Transplantation, 15(2), 166–172.

Stonnington, C. M., et al. (2016). A resilience intervention involving mindfulness training for transplant patients and their caregivers. Clinical Transplantation, 30(11), 1466–1472.