Elizabeth Vandenbogaart, DNP, MSN, CNS, ACNP-BC

Abstract:

Background: Patients hospitalized with life-threatening conditions are exposed to constant psychological stressors that can lead to anxiety and poor patient outcomes. Mindfulness stress reduction interventions have been shown to decrease stress and anxiety with sustained effect. Objectives: This project aims to evaluate the feasibility and effect of a brief mindfulness intervention (MBI) on stress, anxiety, and resilience in advanced heart failure patients, hospitalized awaiting transplant. Methods: A one group, pretest-posttest design over a 4-week period in a single center’s cardiac care units was used. The intervention included a one-on-one mindfulness educational session and a 12-minute audio guided iPad application for daily self-practice. Variables measured at baseline, and every 2 weeks post intervention included stress (The Perceived Stress Scale [PSS)]), anxiety (the Generalized Anxiety Disorder [GAD-7]) and resilience (the Brief Resilience Scale [BRS]), with patient demographics and self-reported mindfulness performance collected. Statistical analysis included descriptive statistics, repeated measures ANOVA with Friedman tests verification, Bonferroni post hoc tests and Wilcoxon matched pairs tests applied. Results: Statistically significant differences were found from baseline to 2 and 4 weeks after intervention in reduced stress (p=.001) and anxiety (p=.001) and increased resilience (p=.001). The greatest change was seen at 2 weeks post intervention and was maintained at 4 weeks. Additionally, feasibility and acceptability of the MBI were evident from the patient experience survey data and focused interview responses. Conclusion: A brief mindfulness intervention holds promise in improving stress, anxiety and resilience for advanced heart failure patients awaiting transplant. Nurses could help to alleviate symptoms of distress through education on use of a mindfulness app in the daily patient care plan. Further study in a larger sample is warranted.

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