Adam W. Hanley et al. (2023). The Mindful Warm-Up: Proof Of Concept For A Brief Embedded Intervention. Mindfulness (2023) 14:1804–1812
https://doi.org/10.1007/s12671-023-02181-w
This Proof of Concept randomized clinical trial research article explores the effectiveness of incorporating brief mindfulness practices into cancer patients’ exercise training sessions to improve their well-being. The paper discusses the growing body of research into very brief Mindfulness Based Interventions (MBIs) which are easier for patients to attend and do not demand the commitment needed for patients to engage in the longer programs which have established efficacy of MBIs in many clinical populations. Instead of traditional lengthy mindfulness programs, this study focused on short mindfulness exercises embedded into existing healthcare routines to make them more accessible. The goal was to investigate how these brief mindfulness activities affected patients’ mental states and overall satisfaction with their care.
There is a review of five RCTS of MBIs embedded in care routines with durations from 3 minutes to 15 minutes. These included preop teaching, waiting room, and pain management counseling. Other settings which occurred to me (T Dowling) could be during radiation treatment for cancer, medication infusions, hemodialysis, in the interval between being seen by a medical technician and seen by the medical provider.
The authors proposed “… using a more comprehensive assessment of mindfulness related phenomenology to investigate participant experiences.” I found this discussion, which includes references to other papers noteworthy. Discussion included “greater mindful awareness of their bodies” , “self-transcendent states”, and “a more allocentric frame of reference”. Self-transcendence is described as “… a transient mental state characterized by decreased self salience and expansive positive emotions like bliss or awe …” which the authors state “… has been infrequently investigated in RCTs of MBIs.” A more allocentric frame of reference is described as “…a vast field of awareness that extends beyond the physical body, into the environment, and potentially into all things.” I’ve added the referenced papers to my (ever-growing) reading list (T Dowling).
Study Design
This was a single-site, two-arm, parallel-group study. The study involved cancer patients participating in an exercise program. They were randomly assigned to either a brief mindfulness warm-up or a mind-wandering task before their training session. The mindfulness warm-up included listening to audio recordings guiding them through mindfulness practice. Subjects in the mindfulness condition listened to a 3-minute audio-recorded mindfulness practice adapted from attention to the breath in the clinic waiting room and a 7-minute audio-recorded mindfulness practice while walking on the treadmill. Subjects in the mind wandering condition (the control) were presented with instructions to “let your mind wander … Try not to think about anything that is bothering you …”.
Measures
Researchers measured factors like mindful state, and phenomenological experiential factors like self-transcendent experiences, spatial frame of reference, and sense of wholeness. Satisfaction with the clinic experience was also measured.
Results
The results showed that the brief mindfulness practices led to increased mindful states and self-transcendent experiences in participants, indicating that these exercises could positively impact how patients felt during and after their exercise sessions. While the study did not find a significant direct effect on overall treatment satisfaction, there was an indirect positive association between increased mindfulness and greater satisfaction. This suggests that enhancing mindfulness before exercise may lead to improved patient satisfaction with their care.
Implications for Healthcare and Further Research
The findings highlight the potential benefits of integrating mindfulness practices into healthcare settings, engaging patients in settings where they are already present for treatment. This study lays the groundwork for further research on how brief, embedded mindfulness interventions can be used to support patients’ overall health and satisfaction with their care.
