Clinical Sciences/Health Conditions
Christopher Wavell, MD
Resident
Division of Physical Medicine & Rehabilitation, Department of Medicine, University of Toronto
Etobicoke, Ontario, Canada
Caitlin Evran, Honours BSc (Candidate), Neuroscience & Biomedical Toxicology
Undergraduate Student
University of Toronto, Trinity College.
Toronto, Ontario, Canada
Emilia Main, Information Specialist
Health Sciences Librarian
University of Toronto
Toronto, Ontario, Canada
Robert Simpson, MD, PhD
Associate Professor
Division of Physical Medicine & Rehabilitation, Department of Medicine, University of Toronto. Toronto Rehabilitation Institute, University Health Network.
Toronto, Ontario, Canada
To map the literature on Mindfulness-based interventions (MBIs) for inpatients on medical, post-surgical, or rehabilitation units using a scoping review.
Design: The Joanna Briggs Institute (JBI) guidance was followed, with reference to the PRISMA-Scoping Review checklist. A protocol was registered on Open Science Framework (ID: B4ZW2). The Population (inpatients), Concept (MBIs), Context (medical, post-surgical, or rehabilitation units) approach was used. Six major electronic databases were searched: MEDLINE, Embase, CINAHL, Web_of_Science, and Cochrane Library with results screened in Covidence. Title and abstract screening were performed by 2 independent reviewers. Data was extracted on eligible studies using JBI categories. All study designs were eligible. MBIs were defined as structured interventions based on Mindfulness-based stress reduction and/or incorporating core MBI practices (breath awareness, body scanning, mindful movement, and psychoeducation).
Results: Twenty-nine studies were eligible. Study designs included randomized controlled trials (15/29), controlled trials (4/29), pre–post studies (7/29), cohort studies (2/29), crossover trial (1/29). Diverse inpatient populations included oncology (n=7), stroke (n=3), post-surgical/orthopaedic (n=3), Spinal cord injury (n=2), traumatic brain injury (n=2), cardiac rehabilitation (n=2), Guillian Barre syndrome (n=1), burns (n=1), and mixed rehabilitation units (n=9). A range of MBIs were used. Psychosocial function (72%) was commonly assessed, followed by mental health (65%), pain (38%), sleep and fatigue (31%), quality of life (31%), physiologic markers (28%), and functional (24%). Adherence to MBIs was high. Consistent improvements were demonstrated in mental health, psychosocial function, pain, sleep, and physiologic stress markers. Adverse events were rare.
Conclusion: MBIs delivered to diverse inpatient medical, post-surgical and rehabilitation populations appear safe, feasible, and potentially effective across a range of outcomes. Limited evidence exists in relation to acceptability, accessibility, and implementation, and this should be the focus of future research in this area.
