Designing a Perioperative Mind-Body Intervention for Peripheral Vascular Interventions.
Chien Yi Maximilian Png, Darshan H Mehta, Anahita Dua, Antonia E Stephen, Alex M Bruce, Aynsley Forsythe, Hovig V Chitilian, Erik J Bringle, James C Simpson, Katherine M Parady, Lisa A Mcneil, Margaret A Baim, Matthew J Eagleton, David C Chang, Gloria Y Yeh
Global advances in integrative medicine and health January 1, 2024 DOI: 10.1177/27536130241285129 via PubMed
Summary
A perioperative mind-body intervention (MBI) consisting of two seven-minute guided meditations—including diaphragmatic breathing, body scans, and guided imagery focused on the leg receiving surgery—was designed for patients undergoing peripheral vascular interventions under procedural sedation. The intervention was developed using the ORBIT model: Phase 1a involved literature review and protocol drafting; Phase 1b used a modified Delphi process with a multi-disciplinary expert panel, reaching consensus after three iterations. The resulting MBI aims to decrease perioperative anxiety and facilitate patient compliance during surgery. A prospective pilot study is planned to test feasibility.
Study at a glance
| Characteristics | Intervention development and refinement Pilot study Peer reviewed |
|---|---|
| Interventions | body scans and guided imagery |
| Keywords | Conscious sedation Integrative medicine Perioperative meditation Vascular surgery |
| Citations | 2 |
| Key finding | A novel perioperative guided meditation intervention was designed through a multi-disciplinary expert consensus process to target anxiety and intraoperative compliance in vascular surgical patients. |
Abstract
Peripheral vascular interventions (PVIs) performed under procedural sedation and analgesia (PSA) can be associated with anxiety and poor compliance with patient instructions during surgery. Mind-body interventions (MBIs) such as meditation have demonstrated the potential to decrease perioperative anxiety, though this area is understudied, and no tailored interventions have been developed for the vascular surgical patient population. We aimed to design a perioperative MBI that specifically targeted vascular surgical patients undergoing PVIs under PSA. We sought to perform this in a scientifically rigorous, multi-disciplinary collaborative manner. Following the Obesity-Related Behavioral Intervention Trials (ORBIT) model, we designed (Phase 1a) and then refined (Phase 1b) a MBI for patients undergoing PVIs under PSA to decrease perioperative anxiety and sedation and facilitate patient intraoperative compliance. Phase 1a involved a literature review, informal information gathering and synthesis, and drafting a preliminary protocol for a perioperative MBI. Phase 1b involved assembling a multi-disciplinary expert panel of perioperative and mind-body clinicians and researchers to improve the MBI using an iterative, modified Delphi approach. The modified Delphi process was completed, and a consensus was reached after three iterations. The resulting MBI consisted of two seven-minute preoperative guided meditations on the day of surgery, including diaphragmatic breathing, body scans, and guided imagery emphasizing awareness of the ipsilateral leg where the vascular surgery was performed. A document delineating the integration of the MBI into the operating room workflow was produced, including details regarding the intervention's timing, duration, and modality. Using a multi-specialty expert panel, we designed a novel MBI in the form of a guided meditation with elements of mindfulness and guided imagery to decrease anxiety and increase intraoperative compliance for patients undergoing PVIs under PSA. A prospective pilot study is being planned to test the program's feasibility.