The role of mindfulness in quality of life of persons with spinal cord injury: a cross-sectional study

Evaluation of mindfulness-based interventions for pain, anxiety, and depression in spinal cord injury patients: A systematic review and meta-analysis

OBJECTIVE

Rehabilitative measures following spinal cord injury (SCI) typically fail to mitigate the psychological symptoms that might heighten pain levels. Mindfulness-based interventions (MBI) have been proposed to address such concerns. We aim to review the literature on MBI used for pain, anxiety, and depression in SCI.

METHODS

A systematic literature search for studies using MBI in patients with pain and psychological symptoms following SCI was conducted. Primary outcomes were pain, assessed by Numeric Pain Rating Scale (NPR) and Brief Pain Inventory (BPI), anxiety, and depression, assessed by the Hospital Anxiety and Depression Scale (HADS). Secondary outcomes included stress and quality of life, as measured by the Perceived Stress Scale (PSS) and World Health Organization Quality of Life (WHO-QOL). Only comparative studies were included.

RESULTS

Seven studies (n = 419) were included pertaining to yoga, mental imagery, biofeedback, and mindfulness meditation. Five studies (n = 260) reported NPR pain. The mean post-treatment difference comparing the control and MBI groups was -1.26 (95 %CI: [-2.44; -0.07]), with MBI showing significant pain reduction (p = 0.04). The intergroup difference was not significant but trended favoring treatment. Three studies included HADS (n = 282) and BPI (n = 203), with neither reaching significance in post-treatment comparisons, but showing improvements favoring MBI for both. Further, changes for MBI groups revealed marginal mood benefits. Secondary outcomes were not statistically analyzed.

CONCLUSIONS

A significant difference was observed regarding NPR post-treatment scores. The results of this study trend positively towards the treatment groups, showing possible benefits in utilizing MBI for patients with SCI suffering from pain and psychological concerns.

HIV Patients' Mindfulness Moderates How Death Anxiety and Depression Impact Life Quality

Many people living with HIV (PLWH) experience death anxiety and depression, which may impact negatively on their health-related quality of life (HRQoL). Mindfulness is a psychological resource that protects against death anxiety and depression and promotes HRQoL. Although a direct association among these variables exist, little is known about their interactive effect. This study examined the role of PLWH mindfulness in the relationship between (a) death anxiety and HRQoL, and (b) depression and HRQoL. Participants included 311 HIV patients (199 women, 122 men, mean age = 30.52) selected from a tertiary healthcare institution in Nigeria. They completed relevant measures. Results showed that mindfulness moderated the effect of death anxiety on HRQoL. Mindfulness also buffered the effect of depression on HRQoL. Clinical efforts to improve HRQoL of PLWH should consider mindfulness-based training program due to its potentials in mitigating the effects of death anxiety and depression on health and recovery.

Mindfulness buffers the association of pain with depression and anxiety among people with spinal cord injury: A cross-sectional study

PURPOSE

Chronic pain is common among people with spinal cord injury (PwSCI) and impacts mental health (MH). Mindfulness may buffer the association of pain with MH, but few studies have examined this among PwSCI. This study examines the extent to which mindfulness moderates the association of pain intensity with MH among PwSCI.

METHOD

PwSCI (N = 64) and chronic pain provided demographic and disability information, ratings of pain intensity (0-10 Numeric Rating Scale), pain interference, depression (eight-item Patient Health Questionnaire [PHQ-8]), anxiety (Generalized Anxiety Disorder-7 [GAD-7]), positive affect/wellbeing (SCI-QOL Positive Affect and Well-Being Short Form [PAWB-SF]), stress (Perceived Stress Scale-4 [PSS-4]), and mindfulness (15-item Five Facet Mindfulness Questionnaire [FFMQ-15]) at the time of their enrollment in a randomized controlled trial of a mindfulness intervention. The present, cross-sectional study used baseline data. Pain intensity, pain interference, mindfulness (FFMQ-15), the Pain Intensity × FFMQ-15 interaction, and relevant covariates were regressed on the four outcome measures (PHQ-8, GAD-7, PAWB-SF, and PSS-4).

RESULTS

There was a significant Pain Intensity × FFMQ-15 interaction effect on PHQ-8 (p = .008) and GAD-7 (p = .021), such that mindfulness buffered the positive relation of pain intensity with depression and anxiety. Additionally, there was a significant Pain Intensity × FFMQ-15 interaction effect on PAWB-SF (p = .032), but contrary to the hypothesis, mindfulness intensified a positive relation between pain intensity and positive affect/well-being.

CONCLUSION

Dispositional mindfulness may buffer the association of pain intensity with depression and anxiety. Examining interventions to enhance mindfulness among PwSCI is warranted. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Effect of a Mindfulness and Motivational Interviewing-Oriented Physical-Psychological Integrative Intervention for Community-Dwelling Spinal Cord Injury Survivors: A Mixed-Methods Randomized Controlled Trial

OBJECTIVE

To evaluate the feasibility, acceptability, and efficacy of a mindfulness and motivational interviewing-oriented physical-psychological integrated intervention in community-dwelling spinal cord injury (SCI) survivors.

DESIGN

A mixed-methods randomized controlled trial.

SETTING

Local organizations for handicapped in Hong Kong.

PARTICIPANTS

Community-dwelling adults with SCI (N=72).

INTERVENTIONS

Participants in the intervention group (n=36) received video-guided exercise for daily practice and online group psychological (mindfulness and motivational interviewing-oriented) weekly sessions for 8 weeks. Participants in the control group (n=36) received an 8-week online group didactic education on lifestyle discussions and general health suggestions.

MAIN OUTCOMES MEASURES

Primary outcomes included quality of life, physical activity, depression, and chronic pain. Secondary outcomes included exercise self-efficacy and mindfulness. Outcomes were measured at baseline, postintervention, and 3-month follow-up. Focus-group interviews were conducted postintervention.

RESULTS

The recruitment, retention, and adherence rates were 84.7%, 100%, and 98.6%, respectively. The intervention showed significant positive effects on preventing declines in quality of life at 3-month follow-up (Cohen d=0.70, 95% CI=0.22-1.18). Positive trends manifested in physical activity, depression, chronic pain, and exercise self-efficacy. Three qualitative categories were identified: subjective improvements in exercise, physical, and social well-being; perceived changes in mindfulness and mental well-being; and intervention facilitators and barriers.

CONCLUSIONS

The mindfulness and motivational interviewing-oriented physical-psychological integrated intervention is feasible and acceptable. The significant prolonged effect in maintaining quality of life and positive effects on physical and psychosocial well-being indicate its value to address major health challenges of community-dwelling SCI survivors.

Predictive factors and quality of life assessment among patients with spinal cord injury in the Middle East: a systematic review

PURPOSE

Spinal cord injury (SCI) is impairment of the spinal cord that adversely affects patients' health and quality of life (QoL). The aim of the study was to assess the quality of life (QoL) and related factors in patients with traumatic spinal cord injury in Middle Eastern countries.

METHODS

PubMed, Ovid Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), EBSCOhost, psycINFO, and Google Scholar were systematically searched for eligible studies published in peer-reviewed journals up till October 2023.

RESULTS

Out of 1060 papers found in the literature, only 18 studies from Iran, Lebanon, and Turkey met the inclusion criteria. The majority of the studies employed the SF-36 scale to assess for QoL. In general, all SCI patients had reduced QoL scores when compared to the healthy population. Some of the factors such as age, education level, the level of injury, time since injury onset, marriage, and job opportunities were correlated with SCI subjects QoL. Our papers were assessed and found to be of both good and high quality.

CONCLUSION

This review emphasizes the significant shortage of QoL studies among SCI patients in the Middle East countries and highlights the importance of improving the QoL of this marginalized population. This work should enhance the governments to establish rehabilitation centers, social and economic support systems, and mental health services to diminish complications arising from SCI.

Mindfulness for health and wellbeing in adults with spinal cord injury: A scoping review

CONTEXT

Individuals with spinal cord injury (SCI) require resources to prevent or self-manage complications in order to maintain optimum functioning and well-being. Rehabilitation literature suggests that mindfulness as an internal psychological resource can play a crucial role in promoting self-management and improving health and well-being.

OBJECTIVES

We sought to identify and synthesize existing evidence on the role of mindfulness and mindfulness-based interventions in health and well-being outcomes among adults with SCI.

METHODS

We conducted a scoping review, searching evidence across four electronic databases, CINAHL, PubMed, PsycINFO, and Web of Science, for articles published between 2000 and 2023. Additional articles were searched from the reference list of identified articles.

RESULTS

Of 354 articles identified in the search, 20 were included in the scoping review. Thirteen studies were interventional in design, while the other seven included cross-sectional and qualitative designs. Some interventional studies examined mindfulness as the major component of the interventions, whereas other studies integrated mindfulness as one component of the intervention program. Overall, mindfulness and mindfulness-based interventions were associated with a range of health and well-being outcomes among individuals with SCI.

CONCLUSIONS

Mindfulness and mindfulness-based interventions appear to positively impact health and well-being in adults with SCI. However, mindfulness interventions were inconsistent in terms of content, delivery frequency, and duration. It is essential to develop multifaceted, tailored mindfulness interventions utilizing a consumer-based approach and established theories of mindfulness and mindfulness-based practices for adults with SCI.

Information Quality and Readability: ChatGPT's Responses to the Most Common Questions About Spinal Cord Injury

OBJECTIVE

This study aimed to assess the quality, readability, and comprehension of texts generated by ChatGPT in response to commonly asked questions about spinal cord injury (SCI).

METHODS

The study utilized Google Trends to identify the most frequently searched keywords related to SCI. The identified keywords were sequentially inputted into ChatGPT, and the resulting responses were assessed for quality using the Ensuring Quality Information for Patients (EQIP) tool. The readability of the texts was analyzed using the Flesch-Kincaid grade level and the Flesch-Kincaid reading ease parameters.

RESULTS

The mean EQIP score of the texts was determined to be 43.02 ± 6.37, the Flesch-Kincaid reading ease score to be 26.24 ± 13.81, and the Flesch-Kincaid grade level was determined to be 14.84 ± 1.79. The analysis revealed significant concerns regarding the quality of texts generated by ChatGPT, indicating serious problems with readability and comprehension. The mean EQIP score was low, suggesting a need for improvement in the accuracy and reliability of the information provided. The Flesch-Kincaid grade level indicated a high linguistic complexity, requiring a level of education equivalent to approximately 14 to 15 years of formal education for comprehension.

CONCLUSIONS

The results of this study show heightened complexity in ChatGPT-generated SCI texts, surpassing optimal health communication readability. ChatGPT currently cannot substitute comprehensive medical consultations. Enhancing text quality could be attainable through dependence on credible sources, the establishment of a scientific board, and collaboration with expert teams. Addressing these concerns could improve text accessibility, empowering patients and facilitating informed decision-making in SCI.