A resilience intervention involving mindfulness training for transplant patients and their caregivers

Abstract

Solid organ and stem cell transplant patients and their caregivers report a substantial level of distress. Mindfulness-based stress reduction has been shown to alleviate distress associated with transplant, but there is limited experience in this population with other mindfulness-based interventions, or with combined transplant patient and caregiver interventions. We evaluated a novel, 6-week mindfulness-based resilience training (MBRT) class for transplant patients and their caregivers that incorporates mindfulness practice, yoga, and neuroscience of stress and resilience. Thirty-one heart, liver, kidney/pancreas, and stem cell transplant patients and 18 caregivers at Mayo Clinic in Arizona participated. Measures of stress, resilience, depression, anxiety, health-related quality of life, positive and negative affect, and sleep were completed at baseline, 6 weeks, and 3 months postintervention. At 6 weeks and 3 months, patients demonstrated significant (P<.005) improvements from baseline in measures of perceived stress, depression, anxiety, and negative affect. Quality-of-life mental component (P=.006) and positive affect (P=.02) also improved at follow-up. Most participants adhered to the program, were satisfied with class length and frequency, and reported improved well-being as a result of the class. MBRT holds promise as an intervention to enhance resilience and manage stress for transplant patients and their caregivers.

Improving Communication between Physicians and Their Patients through Mindfulness and Compassion-Based Strategies: A Narrative Review

“…MBSR [29] has been successfully applied to healthcare professionals to reduce stress-related symptoms, including burnout [42,43], and to increase self-compassion, resilience, and well-being [44,45]. A modified and extended MBSR program for primary physicians offered by Krasner et al [46], resulted in self-reported improvements in mindfulness, burnout, empathy and responsiveness to psychosocial aspects of patients’ problems, mood disturbance, emotional stability, conscientiousness, and engagement at work.…”

Evaluating resilience as a predictor of outcomes in lung transplant candidates

“…In an inpatient cohort of adolescents with cystic fibrosis (N = 10), a pilot intervention focused on promoting resilience in stress management (PRISM) was both acceptable and feasible with an 80% completion rate 50 . Stonnington et al 18 piloted a six‐week mindfulness‐based resiliency training class for pre‐and post‐solid organ and stem cell transplant patients (N = 31) and their caregivers (N = 18); results showed a trend toward end‐of‐study improvement in RISC scores (mean increase = 3, P = .085). The resilience intervention demonstrated improvements in patients’ QOL and positive affect with reductions in stress, anxiety and depression 18 .…”

“…Following lung transplantation, resilience has been associated with lower levels of depression and post‐traumatic stress disorder (PTSD) 17 . Interventions to enhance resilience are available 18 and provide opportunities to potentially optimize lung transplant candidacy and alleviate distress. Resilience in candidates prior to lung transplantation has not been well studied, although it has been gaining attention in other solid organ transplant fields 19‐22 …”

A Qualitative Study of Caregivers’ Experiences, Motivation and Challenges Using a Web-Based Mindfulness Intervention

“…There is a growing research interest in the efficacy of MBI's effects for specific populations, including health care professionals and caregivers (Banerjee et al 2017;Chiesa et al 2017). Studies of patient populations and their caregivers (Birnie et al 2010;Li et al 2016;Longacre 2013;Stonnington et al 2016) show beneficial effects of MBI (MBSR) regarding self-rated psychological symptoms (e.g. depression, anxiety, stress, mindfulness) (Li et al 2016) and the potential to improve well-being among caregivers (Stonnington et al 2016).…”

“…Studies of patient populations and their caregivers (Birnie et al 2010;Li et al 2016;Longacre 2013;Stonnington et al 2016) show beneficial effects of MBI (MBSR) regarding self-rated psychological symptoms (e.g. depression, anxiety, stress, mindfulness) (Li et al 2016) and the potential to improve well-being among caregivers (Stonnington et al 2016). The possibility to involve both patients and caregivers may also increase feasibility for caregivers that cannot leave the patient home alone (Li et al 2016).…”