Mindfulness-based Stress Reduction Program Research Articles

The role of meditation and mindfulness in the management of polycystic ovary syndrome: a scoping review

Polycystic Ovary Syndrome (PCOS) presents multifaceted challenges affecting women’s reproductive, metabolic, and psychological systems, consequently impacting their psychological and emotional well-being. The utilization of meditation and mindfulness interventions (MMIs) is found to be increasing for the management of PCOS. This scoping review systematically explored the current literature to identify the type and application of MMIs for PCOS management. A systematic search of literature was conducted using CINAHL, PsycINFO, Scopus, MEDLINE, and PubMed databases for identifying studies conducted on the usage of MMIs in women diagnosed with PCOS, irrespective of age. The comprehensive search identified 14 trials (comprising 17 citations) meeting inclusion criteria, involving 723 participants across various age groups. Among these, nine were randomized controlled trials (RCTs), while the remaining comprised non-RCTs. Several types of MMIs, including Rajayoga of Brahmakumaris, Yoga Nidra, OM cyclic meditation, unspecified forms of meditation, mindfulness-based stress reduction programs, mindful yoga, and mindfulness-based activities, were used. Outcomes were predominantly assessed in psychological domains (n=11), followed by anthropometric (n=9), quality of life (n=7), and metabolic metrics (n=7). The review findings suggest the integration of meditation with conventional treatment modalities. Preliminary data indicate that MMIs have the potential to improve psychosocial well-being and quality of life among PCOS-affected women. However, adequately powered studies with extended follow-up periods are required to investigate the mechanisms and therapeutic efficacy of MMIs, particularly concerning reproductive outcomes and weight management. Furthermore, diligent monitoring and reporting of adverse events and adherence are essential for a comprehensive understanding of MMI utilization in PCOS management.

Mechanisms of Mindfulness: A Longitudinal Study of a Mindfulness-Based Stress Reduction Program

Mechanisms of Mindfulness: A Longitudinal Study of a Mindfulness-Based Stress Reduction Program

The effect of conscious mindfulness-based informative approaches on managing symptoms in hemodialysis patients

IntroductionThe research was conducted to determine the effect of conscious mindfulness based informative approaches applied in hemodialysis patients on reducing stress and managing symptoms.MethodsThis research was conducted as a real experimental model with a control group. Research population consisted of 160 hemodialysis patients. The sample of the study was determined as 120 hemodialysis patients in total, 60 in the experimental and 60 in the control group, as a result of the power analysis. After the pre-test application, a mindfulness-based stress reduction program was applied to the experimental group. In the analysis of the data collected in the research, percentage, frequency, chi-square analysis, t-test for independent groups, t-test for dependent groups were used by means of SPSS for Windows 22.00 statistical software package.ResultsThe t-test analyses of the differences between pre-test and post-test scores of hemodialysis patients in the experimental group were found to be significant in favor of the post-tests.DiscussionIt was found out that the conscious mindfulness-based informative approaches decreased the perceived stress and anxiety of the patients in the experimental group, whereas increased their levels of conscious mindfulness and symptom management.

Abstract PO5-11-09: Participants’ experience with an online mindfulness-based stress reduction intervention for anxiety management in breast cancer survivors: A secondary analysis of a randomized trial

Abstract Background Breast cancer (BC) diagnosis and treatment can lead to multiple symptoms with a negative impact on the quality of life of survivors. Mindfulness-based stress reduction (MBSR) interventions have shown to improve anxiety, depression, and stress in patients with cancer across multiple settings. However, the effectiveness of an online MBSR program has not been studied. Methods This is an explanatory qualitative sub-study of a randomized trial of an online MBSR intervention versus a waitlist control. Participants were Mexican women aged ≥18 years diagnosed with stage 0-III BC 1-5 years prior to inclusion, not currently undergoing chemotherapy or radiotherapy, with moderate to severe anxiety (baseline GAD-7 score ≥10). The intervention consisted of 8 weekly 2-hour Zoom sessions with body scan meditation and yoga practice led by a certified instructor. Participants received a digital manual with exercises, audio for guided practice, and a video of postures for balance and flexibility. The primary outcome of the trial was anxiety at 2, 5, and 8 months after the intervention. Two focus groups were conducted via Zoom; 21 participants from the intervention arm were selected and invited according to the difference in GAD-7 scores between baseline and 8 months. The first group consisted of 7 participants (median age 53 years, range 39-62) with a decrease in GAD-7 score of ≥4 points (mean -9.1, SD 3.7); the second group consisted of 7 participants (median age 54 years, range 44-64) with a decrease of < 4 points or an increase in GAD-7 score (mean -1.2, SD 1.9). Each focus group was conducted 14 and 9 months after the MBSR intervention, respectively, and had a duration of 110 and 113 minutes, respectively. Audio and video were recorded and transcribed verbatim. Transcripts were analyzed and themes were developed, focusing on participants’ experience with the online intervention and its perceived benefits. Results The weekly sessions and at-home practice functioned as a “personal haven” for participants. At-home deliberate practice and the additional audio and video materials were considered essential for the effectiveness of the intervention. Participants no longer needed to consciously follow step-by-step directions, as the practices had become a part of who they were, even several months after the intervention. Breathing exercises were frequently used by participants on a day- to-day basis. Regarding the mindfulness practice itself, some participants indicated that they noticed positive changes in their character and demeanor, and in their reactions to everyday and BC-related stressors, including situations such as medical consultations and possible news regarding their treatment. In that sense, they mentioned that all they learned is useful for their life in general, and not exclusive to BC survivors. Despite differences in improvement of anxiety by GAD-7 scores between the focus groups, most participants in both groups referred to the intervention as “life-changing”. Most participants in both groups perceived the online format of the intervention as positive: it allowed them to join in from any location and fit the program into their daily routine with less time commitment. Likewise, the privacy of their homes made them feel more comfortable expressing themselves during the weekly sessions. A high level of recognition, appreciation and gratitude towards the instructor was observed. Some participants noted that contact with the instructor and other participants was limited due to the online format, preventing them from forming friendships or a sense of community. Conclusion BC survivors’ opinion of an online MBSR program was largely positive regarding the benefits of the intervention and its delivery format. Moreover, the intervention was successful at facilitating participants’ adoption of mindfulness practice in their daily lives and at improving other aspects of their lives beyond BC. Citation Format: Haydee Cristina Verduzco-Aguirre, Maura Pompa Mansilla, Misael Salazar-Alejo, Javier Gutierrez Ornelas, Fernanda Mesa-Chavez, Ana Ferrigno Guajardo, Cynthia Villarreal-Garza. Participants’ experience with an online mindfulness-based stress reduction intervention for anxiety management in breast cancer survivors: A secondary analysis of a randomized trial [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-11-09.

An online self-study mindfulness-based stress reduction course for people suffering from mental fatigue after an acquired brain injury

ABSTRACT Objective The Mindfulness-Based Stress Reduction (MBSR) program has shown promising results for people suffering from mental fatigue after an acquired brain injury. The aim was to evaluate the feasibility of a MBSR program performed as an online self-study course for this group of people. Methods Sixty participants who had suffered an acquired brain injury with lasting mental fatigue were randomized to an online MBSR course or to a waitlist control group. They answered self-report questionnaires before start and after the course. Results Sixteen completed the MBSR program. With the repeated ANOVA no significant difference between groups was found, although there was a significant change in time (the repetition factor). The post-hoc paired t-test indicated a significant reduction and a large-to-median effect size in mental fatigue (p = 0.003, d = 0.896), depression (p = 0.038, d = 0.569) and anxiety (p = 0.030, d = 0.598) for the MBSR group. No significant changes were found for the control group. Conclusion An online self-study MBSR program for people suffering from mental fatigue after an acquired brain injury can be a feasible option for those suffering from less severe mental fatigue and emotional symptoms, while others may require a program adapted to their needs.

Mindfulness, spiritual well-being, and sustainable consumer behavior

Although there has been considerable research interest in how mindfulness affects consumers’ pro-environmental behaviors, extant research has not fully clarified the underlying mechanisms through which mindfulness is related to sustainable consumption. This study examines mediating effects of spiritual well-being in regard to the relationship between mindfulness and sustainable consumer behavior. Four different types of sustainable consumer behavior are examined: general ethically minded consumer behavior, voluntary simplicity, direct environmental behavior, and support for green products. The study was conducted with 467 French consumers: 208 consumers who have undertaken formal mindfulness training (mindfulness-based stress reduction program) and 259 consumers who have never undertaken any mindfulness training. The findings show that mindfulness is related to sustainable consumer behavior through the personal, communal, and environmental domains of spiritual well-being. However, the links between mindfulness and spiritual (personal, communal, and environmental) well-being are primarily evident only among consumers who have undertaken formal mindfulness training. Thus, this research demonstrates how mindfulness affects sustainable consumer behavior and identifies conditions under which these effects are observed. Policy recommendations in the form of supporting and subsidising mindfulness training programs and other initiatives that enhance spiritual well-being, to facilitate greater sustainable consumer behavior are proposed.

Virtual Mindfulness-Based Therapy for the Management of Endometriosis Chronic Pelvic Pain: A Novel Delivery Platform to Increase Access to Care

ObjectivesThis study assessed the effectiveness of a virtual mindfulness-based stress reduction (MBSR) program to improve quality of life and pain in people with endometriosis. MethodsThis was a multiple-method, before and after study design. Fifteen patients with a clinical or surgical diagnosis of endometriosis were recruited from a Canadian outpatient gynaecology clinic. Participants completed the Endometriosis Health Profile, a validated survey tool, and a pain medication use questionnaire before and after a virtual 8-week MBSR program run by an experienced social worker. A focus group was held upon completion of the program to assess participants’ experiences using mindfulness for management of endometriosis symptoms. Quantitative data was analyzed with paired-samples t tests. Qualitative data was thematically analyzed. ResultsA total of 67% of people enrolled completed the MBSR course (10/15). Following the MBSR program, participants had a statistically significant decrease in 4 components of the Endometriosis Health Profile: control and powerlessness (P = 0.012), emotional well-being (P = 0.048), social support (P = 0.030), and self-image (P = 0.014). There was no change in pain scores or medication use. Participants felt the program’s benefits came from a sense of community, education about their condition, and application of mindfulness tools when approaching pain. Participants felt more comfortable with the virtual format over in-person sessions. ConclusionsA virtual MBSR course can improve quality of life domains in people with endometriosis. The virtual format was effective and preferred by participants. Virtual MBSR programs may increase access to this type of care.

Mindfulness-based stress reduction for elementary school teachers: a randomized controlled trial

Educators frequently grapple with elevated levels of job-related stress, heightening the risk of mental health issues. Although Mindfulness-Based Stress Reduction (MBSR) has demonstrated effectiveness in reducing stress among the general populace, its implementation among educators, especially in non-United States settings, has received limited exploration. This pre-registered randomized-controlled trial investigates the effectiveness of the standard MBSR in reducing perceived stress among Dutch elementary school teachers. Additionally, it examines the impact of MBSR on mindfulness skills, emotion regulation, and self-compassion as secondary proximal outcomes, along with exploring its influence on teacher self-efficacy, perceived pupil-teacher relationships, and classroom climate quality as secondary distal outcomes. Involving 146 teachers randomly assigned to either the intervention (n = 72) or waitlist-control condition (n = 74), assessments were conducted pre- and post-intervention or control period, with a 3-month follow-up. Participants in the intervention reported significantly lower perceived stress compared to the control group, demonstrating a substantial effect size at post-treatment (d = −0.84) and a moderate effect at follow-up (d = −0.69). MBSR not only yielded improvements in personal well-being but also positively impacted teacher self-efficacy and classroom climate quality at both post-treatment and follow-up. These positive outcomes aligned with enhancements in mindfulness skills, emotion regulation, and self-compassion. However, no significant effects were observed on the pupil-teacher relationship. Exploratory analyses revealed no moderation effects based on past or present psychological problems, school weight/pupil population, years of experience, or age on perceived stress at post-measurement. Furthermore, the study examined the potential influence of COVID-19 on the results, concluding that the pandemic had no discernible impact. These findings advocate for the widespread adoption of the standard MBSR program as a means of enhancing the well-being of elementary school teachers.

The Effect of Mindfulness-Based Stress Reduction Program on Stress and Quality of Life in Family Caregivers of Patients with Cancer: Randomized Controlled Trial

Abstract Objectives The study aimed to examine the effects of an online Mindfulness-Based Stress Reduction program on stress and quality of life levels of family caregivers of cancer patients. Method The study used a randomized controlled trial design with a pre-test (T1), follow-up (T2) and post-test (T3) which was conducted with 104 family caregivers of cancer patients. Data collection was conducted using the Caregiver and Patient Descriptive Information Form, Caregiver’s Stress Scale and The Caregiver Quality of Life Index Cancer Scale. T1 measurements were conducted for experimental (n = 50) and control groups (n = 54). After the 8-week online Mindfulness-Based Stress Reduction program of the experimental group, T2 measurements were taken for both groups. Four weeks later, the T3 measurement was collected for both experimental and control groups. Results A statistically significant difference over time was detected between the mean Caregiver’s Stress Scale scores of the experimental group in the T1, T2, and T3. There was no significant difference in the control group over time. A statistically significant difference was detected in the mean Caregiver Quality of Life Index Cancer Scale total score of the experimental group across T1, T2, and T3. When the scale pre-test mean scores were compared between the groups, no significant differences were detected for T1, but a statistically significant difference was found between the T2 and T3 scores. Conclusion In the study, it was determined that the online Mindfulness-Based Stress Reduction program had an effect on reducing stress and improving the quality of life. Preregistration The research was registered on http://clinicaltrials.gov (ID:NCT05831293).

Protocol for a pilot study assessing a virtual mindfulness intervention for postpartum African American women

Elevated perinatal depressive symptoms are more common among disadvantaged African American women, and they are almost four times as likely to have postpartum posttraumatic stress compared to white women. For new mothers, depressive symptoms and posttraumatic stress can lead to negative parenting, poor mother-infant bonding, and delayed infant development. For African American women, a culturally adapted mindfulness-based intervention offers great potential as an acceptable approach to reduce psycho-behavioral symptoms and improve mother-infant interactions (i.e., bonding). Additionally, it is critical that mindfulness interventions consider time constraints of new mothers, provide accessible intervention delivery, address parenting, and consider the challenges of caring for an infant. Given these considerations, we describe a pilot research protocol in which we evaluate a culturally adapted mindfulness program: Mindfulness for African Americans Postpartum (MAAP). The intervention is based upon Kabat-Zinn’s Mindfulness Based Stress Reduction program, but is adapted to include culturally relevant concepts of spirituality, inter-dependence, self-empowerment, and storytelling, which are salient to African American culture. To accommodate the needs of new mothers, a certified mindfulness interventionist delivers each session virtually using Zoom. The investigation uses a randomized controlled design in which African American women within 12 months of giving birth are randomized either to the MAAP intervention or to an Education Program. The primary aim is to determine the extent to which the MAAP intervention decreases maternal psycho-behavioral symptoms (perceived stress, depressive symptoms, anxiety, poor sleep, posttraumatic stress, and fatigue) and improves mother-infant bonding. A secondary aim is to explore the effects of MAAP on proinflammatory cytokines and oxytocin. Culturally adapted mindfulness interventions delivered virtually will make mindfulness more accessible and meaningful to populations, like African American new mothers, who are at higher risk for postpartum mood disorders and poor infant outcomes.

IJCM_343A: Mindful Beginnings: Evaluating the Effects of Mindfulness-Based Stress Reduction on Mental Health and Academic Performance in First-Year Medical Students- A Randomized Controlled Trial

Background: The demanding nature of medical education poses unique challenges to the mental health and academic performance of first-year medical students. The transition into the rigorous medical curriculum, coupled with the high-stakes environment of healthcare, often leads to increased stress levels and potential negative impacts on well-being. Mindfulness-Based Stress Reduction (MBSR) has emerged as a promising intervention to address these challenges. Objective: To evaluate the effect of Mindfulness-Based Stress Reduction on the Mental health and Academic performance of first-year medical students in a teaching medical institute by randomized controlled trial (RCT) Methodology: An RCT was conducted from May 2023 to July 2023, involving first-year medical students in a self-financing medical college. A total of 227 students participated, randomly assigned to either the intervention group, which underwent an eight-week MBSR program incorporating mindfulness meditation and stress reduction techniques, or the control group, receiving conventional medical education without mindfulness training. Data collection for both pre-and post-tests utilized a comprehensive questionnaire-based interview, incorporating validated instruments such as the Perceived Stress Scale (PSS), the Pittsburgh Sleep Quality Index (PSQI), and The Epworth Sleepiness Scale (ESS). The collected data will be analyzed using SPSS version 26. Descriptive and Inferential statistics will be applied to compare outcomes between the intervention and control groups, with statistical significance set at p < 0.05. Results: A total of 227 students participated, with 110 in the control arm and 117 in the intervention arm. Further data analysis is currently in progress and will be presented during the upcoming presentation. Conclusion: Stress is prevalent in medical students and has adverse effects on students mental health. Mindfulness practice has wide-ranging positive effects and would be beneficial as a stress reduction and preventative mental health intervention.

Stress and primary headaches – Mindfulness-Based Stress Reduction (MBSR) as a novel avenue for treatment

Introduction: In today's fast-paced life, an increasing number of people are experiencing chronic stress, which negatively impacts our mental and physical health, leading to troublesome conditions such as primary headaches. Faced with this challenge, more individuals are turning their attention to mindfulness techniques as an effective tool for stress management. In light of this, mindfulness, focusing on the awareness of the present moment, emerges as a promising method for preventing and alleviating stress-induced headaches and the resulting aftermath. 
 Purpose: Offer a comprehensive overview of the current understanding of the efficacy of mindfulness training, particularly Mindfulness-Based Stress Reduction (MBSR), in the prevention and relief of primary headaches and their associated consequences. 
 Description of the state of knowledge: MBSR demonstrates the potential for effectively coping with stress-induced headaches and their subsequent effects, including disability related to headaches. This category of pain includes conditions like migraine and tension-type headaches. In the clinical trials conducted thus far participants in the MBSR program show noticeable improvement in headache-related disability, self-efficacy, quality of life, catastrophic pain, and depression scores. 
 Summary: Studies suggest that integrating mindfulness training could present a promising strategy for preventing and reducing the severity of primary headaches and their consequences, by mitigating stress, a crucial factor influencing the onset of these headaches. To validate these promising findings, further randomized, large-scale, placebo-controlled studies are required.

Examining the feasibility and acceptability of an online mindfulness-based stress reduction program for frontline child protection social workers in England

ABSTRACT This study explores the feasibility and acceptability of an online mindfulness-based intervention (O-MBI) for stress prevention and reduction among frontline child protection social workers (F-CPSWs) in England. In Phase I, a non-randomized, one-arm feasibility study (N=104) demonstrated post-O-MBI reductions in perceived stress and increased mindfulness. Phase II employed a phenomenological approach using semi-structured interviews (n=7). Participants suggested adjustments to content, delivery, and design, highlighting the need for customization. Despite promising results, the study underscores the importance of tailoring interventions to individual needs and circumstances. Future research should delve into O-MBI effectiveness with a more diverse F-CPSW sample.

The effects of a mindfulness-based stress reduction program and deep relaxation exercises on pregnancy-related anxiety levels: A randomized controlled trial.

The present study aimed to examine the effects of a mindfulness-based stress reduction (MBSR) program and deep relaxation exercises on pregnancy-related anxiety levels. This randomized parallel-group controlled trial was conducted with 95 pregnant women (MBSR: n = 32, deep relaxation exercises: n = 31, control: n = 32) between 1 August and 15 October 2022 with pregnant women who were registered at the pregnancy outpatient clinics of a hospital in the Southeastern Anatolia Region of Türkiye. CONSORT guidelines were followed in our study. The participants in the MBSR group were given an eight-session MBSR program, consisting of two sessions per week for 4 weeks, whereas the participants in the deep relaxation exercises group were asked to do exercises at home with deep relaxation videos four times a week for 4 weeks. The participants in the control group received only routine prenatal care. The mean PRAQ-R2 Fear of Giving Birth subscale scores of the participants in the MBSR and deep relaxation exercises groups after the intervention were lower than that of the participants in the control group. Additionally, the mean total PRAQ-R2, PRAQ-R2 Worries about Bearing a Physically or Mentally Handicapped Child subscale and PRAQ-R2 Concern about One's Own Appearance subscale scores of the participants in the MBSR group were found to be significantly lower than the scores of those in the deep relaxation exercises and control groups (p < 0.001). The MBSR program is an effective method for reducing pregnancy-related anxiety levels. Additionally, deep relaxation exercises are alternative practices for reducing the fear of giving birth among pregnant women. NCT05447000.

Effect of mindfulness-based stress reduction (MBSR) program on depression, emotion regulation, and sleep problems: A randomized controlled trial study on depressed elderly

BackgroundEntering old age is associated with various physical and psychological disabilities. Therefore, the aim of this study is to determine the effect of mindfulness-based stress reduction program on emotion regulation and sleep problems in depressed elderly.MethodsThis study was a clinical trial conducted on 60 elderly individuals with depression using purposive sampling. These elderly were referred by geriatricians and were included in the study based on the inclusion criteria. The participants were randomly assigned to two groups: the Mindfulness-Based Stress Reduction (MBSR) group and the control group. Both groups completed the Geriatric Depression Scale (GDS), the Gratz and Roemer Emotion Regulation Questionnaire, and the Pittsburgh Sleep Quality Index before and after the intervention. The MBSR sessions were held for the experimental group in 8 sessions of 90 min each, once a week. Finally, all the data were analyzed using SPSS software version 26 through descriptive and analytical statistics such as mean and standard deviation, t-tests and mixed analysis of covariance (ANCOVA) with repeated measures.ResultsThe results showed that the MBSR intervention led to a significant reduction in depression symptoms (p < 0.001) and improvement in emotion regulation and sleep quality (p < 0.001) among the elderly participants with depression in the intervention group.DiscussionThe results of this study showed that MBSR can be effective in reducing depression levels, improving emotion regulation, and sleep quality among depressed elderly individuals compared to the control group. Caregivers and psychotherapists of nursing homes can use care programs such as MBSR program to improve the physical and mental condition of the elderly.Trial registrationFirst Registration: 13/01/2022, Registration Number: IRCT20211118053099N1, Access: https://www.irct.ir/trial/61207.

Comparing the Effectiveness of Schema Therapy and Mindfulness-Based Stress Reduction Program on Sexual Satisfaction in Married Individuals

Objective: The present research aimed to compare the effectiveness of schema therapy and a mindfulness-based stress reduction program on sexual satisfaction among married individuals. Method: This quasi-experimental study employed a pretest-posttest design with a one-month follow-up and included a control group. The study population consisted of all married individuals with marital issues who visited the Khodbidari Psychological Center in the first half of 2019, totaling approximately 180 individuals. From this group, 45 individuals were selected through purposive sampling and randomly assigned to three groups of 15. The experimental groups underwent 8 sessions of 90-minute schema therapy by Young et al. (2003) and the mindfulness-based stress reduction program by Kabat-Zinn (2003), while no intervention was performed for the control group. The data collection tool was the Sexual Satisfaction Scale (Larson et al., 1998). The data were analyzed using SPSS software version 21 and repeated measures ANOVA. Findings: The results indicated that there was a significant difference in sexual satisfaction scores among the groups (p = 0.001, F = 21.58), and both schema therapy and the mindfulness-based stress reduction program increased sexual satisfaction among married individuals. Furthermore, there was no significant difference between the two groups in this regard (p &lt; 0.05). Conclusion: According to the results, both schema therapy and the mindfulness-based stress reduction program can be used to improve sexual satisfaction in married individuals.

Non-pharmacological interventions feasible in the nursing scope of practice for pain relief in palliative care patients: a systematic review.

Palliative care patients desire more symptom management interventions that are complementary to their medical treatment. Within the multi-professional team, nurses could help support pain management with non-pharmacological interventions feasible for their practice and adaptable to palliative care patients' needs. The objective was to identify non-pharmacological interventions feasible in the nursing scope of practice affecting pain in palliative care patients. A systematic review. A defined search strategy was used in PubMed, CINAHL, PsycINFO, and Embase. Search results were screened double-blinded. Methodological quality was double-appraised with the Joanna Briggs Institute Critical Appraisal Tools. Data were extracted from selected studies and the findings were summarized. The methodological quality, quantity of studies evaluating the same intervention, and consistency in the findings were synthesized in a best-evidence synthesis to rank evidence as strong, moderate, limited, mixed, or insufficient. Out of 2385 articles, 22 studies highlighted non-pharmacological interventions in the nursing scope of practice. Interventions using massage therapy and virtual reality demonstrated most evidentiary support for pain management, while art therapy lacked sufficient evidence. Mindful breathing intervention showed no significant reduction in pain. Hypnosis, progressive muscle-relaxation-interactive-guided imagery, cognitive-behavioral audiotapes, wrapped warm footbath, reflexology, and music therapy exhibited promising results in pain reduction, whereas mindfulness-based stress reduction program, aromatherapy, and aroma-massage therapy did not. Despite not all studies reaching significant changes in pain scores, non-pharmacological interventions can be clinically relevant to palliative care patients. Its use should be discussed for its potential value and nurses to be trained for safe practice. Methodologically rigorous research for non-pharmacological interventions in nursing scope of practice for pain relief in palliative care patients is necessary. The protocol for this study is registered in the International Prospective Register of Systematic Review (PROSPERO registration number: CRD42020196781).

Comparison of the Effectiveness of Mindfulness-Based Stress Reduction Program with Transcranial Direct Current Stimulation on Stress and Rumination in Adolescents with Cancer

Objective: Considering the necessity to identify effective interventions to improve stress and rumination in students, the current study aimed to compare the effectiveness of a mindfulness-based stress reduction program with transcranial direct current stimulation (tDCS) on stress and rumination in adolescents with cancer. Methods and Materials: The research method was a quasi-experimental pre-test and post-test with a control group design. The research population included all adolescents with cancer at Mahak Hospital in Tehran, from which 40 individuals were selected through purposive sampling and randomly assigned to three groups (1- Mindfulness-based stress reduction training; 2- Transcranial direct current stimulation intervention; 3- A combined method of mindfulness-based stress reduction with transcranial direct current stimulation) and one control group. The instruments for data collection included the Lovibond and Lovibond's (1995) Depression, Anxiety, and Stress Scale and the Ruminative Response Scale about an interpersonal upset (2008). For data analysis, one-way analysis of covariance, repeated measures analysis of variance, and the least significant difference post-hoc test were used. Findings: The results of the covariance analysis along with the post-hoc tests showed that there is no significant difference between the mindfulness-based stress reduction method and tDCS in reducing stress levels (P&gt;0.05), and only the difference between these methods compared to the control group was significant (P&lt;0.05). In terms of the effectiveness of the interventions under study on stress levels, the combined method was more effective than using each method separately. Regarding the rumination variable, there was no significant difference between the mindfulness-based stress reduction method and the tDCS method in reducing the level of rumination (P&gt;0.05), and only the difference of this mindfulness method compared to the control group was significant (P&lt;0.05). The results of the repeated measures analysis of variance along with the post-hoc tests indicated that there were no significant differences between the post-test and follow-up stages for stress and rumination variables (P&gt;0.05); hence, the results were stable. Conclusion: Based on the results of the current study, counseling and psychology units established in hospitals and oncology clinics need to be more aware of the mental health of adolescents with cancer and should use the combined method of mindfulness-based stress reduction with tDCS to improve stress and rumination in adolescents with cancer.

Challenge or Threat? The Effects of the Standard and a Second-Generation Mindfulness Intervention with Buddhist Practices on Cognitive Appraisals of Stress: Secondary Analysis of a Randomized Controlled Experiment Performed in Switzerland.

Contemplative approaches rooted in Buddhist traditions have been linked to the attenuation of response to social stress. Anticipatory cognitive appraisals of social situations potentially represent a mechanism explaining the stress-reducing effects of contemplative practices. The cognitive appraisal of threat is associated with an anticipated loss of social self-esteem. In contrast, the cognitive appraisal of challenge involves recognizing the potential for gain or growth in stressful situations and is associated with a more adaptive cardiovascular response. In this secondary analysis of a randomized controlled experiment performed in Switzerland, we evaluated the effects of two contemplative interventions on cognitive appraisals of challenge and threat and associated physiological profiles. The interventions were a standard Mindfulness-Based Stress Reduction (MBSR) program and a new program (MBSR-B), which included several elements from Buddhist practices. After an eight-week intervention, participants completed the Trier Social Stress Test (TSST) and underwent the assessment of primary cognitive appraisals and cardiovascular response to stress. The results demonstrated greater challenge appraisal in the MBSR (n = 20) and MBSR-B (n = 21) groups compared to Control (n = 24), and MBSR-B participants scored higher on the challenge than threat appraisal. At the physiological level, the groups did not differ on changes in cardiac output and total peripheral resistance. Still, an exploratory analysis demonstrated that the MBSR-B group's cardiovascular profile best resembled challenge appraisal. The results suggest that contemplative approaches foster challenge appraisal, contributing to a more adaptive response to stress.

Evaluation of a Modified Mindfulness-Based Stress Reduction Intervention for Adults with Cerebral Palsy and Anxiety and/or Emotion Regulation Difficulties-A Randomised Control Trial.

Mindfulness-Based Stress Reduction (MBSR) has not yet been evaluated for people with cerebral palsy (CP). The aims of this randomised control trial were to investigate whether a modified telehealth MBSR program could improve mindfulness and reduce depression, anxiety, and emotion regulation difficulties among adults with CP with elevated anxiety and/or emotional regulation difficulties. Participants (n = 31) with elevated anxiety and/or emotion regulation difficulties and no/mild intellectual impairment were randomised to a modified telehealth MBSR program (90 min weekly, 9 weeks) group or a wait-list group. Measurements were collected prior to (T1), after (T2), and 8 weeks post-intervention (T3). The primary outcome was the mean between-group difference in the change in Cognitive and Affective Mindfulness Scale-R (CAMS-R) scores in T1-T2. The secondary outcomes included mean within-group differences over time for the CAMS-R total scores, Depression Anxiety and Stress Scale-21 subscales, and Difficulties in Emotion Regulation Scale (DERS) total t-score. We found no statistically significant between-group difference in mean change in mindfulness scores for T1-T2 (primary outcome). Secondary outcomes: The MBSR intervention group had improved CAMS-R scores with respect to T1-T2 and T1-T3; improved mean scores for Depression and Stress subscales for T1-T2; and improved DERS t-scores for T1-T2 and T1-T3. In conclusion, this study found no significant between-group difference for the primary outcome of mindfulness. The MBSR program was successfully modified for adults with CP and was effective in improving depression, stress, and emotion regulation. ACTRN12621000960853.