Development, implementation, and acceptability of a bedside mindfulness intervention for adults with sickle cell disease.

A bedside mindfulness intervention was developed and tested for patients with sickle cell disease experiencing acute pain during infusion sessions. The intervention was designed with input from clinicians and patients. In interviews, 11 patients expressed interest in mindfulness skills and a need for personalized, non-pharmacological pain management. Among 14 participants who completed surveys, most liked the intervention and agreed it could help manage disease-related distress. Self-reported mindfulness increased after the sessions. These preliminary results support further development of mindfulness-based services to help individuals with sickle cell disease manage pain and psychological difficulties.

Study at a glance

Abstract

Acute and chronic pain are the most frequent complications of sickle cell disease (SCD), often severely reducing quality of life and requiring management with long-term pharmacological interventions. A biopsychosocial approach conceptualizing pain in SCD as the result of complex biological, psychological, and social factors could facilitate targeted behavioral interventions. Mindfulness is one procedure for management of pain in individuals with chronic pain/illness. The goal of the current project was to design and implement a bedside mindfulness intervention to help patients with SCD enhance self-efficacy of pain management and reduce distress. As part of a quality improvement project in SCD clinics in a large health system, we developed a bedside mindfulness intervention to be provided during infusion sessions for patients presenting for acute vaso-occlusive episodes (VOE). The approach to development and implementation involved engagement of professionals working directly with patients. Concept planning meetings with these professionals along with qualitative patient and provider feedback informed feasibility, design, and intervention application. During a quantitative phase, patients completed validated surveys items on acceptability. Interview data (N = 11) supported patient interest in mindfulness skills and highlighted a need for tailored, person-centered interventions and non-pharmacological treatment strategies. On quantitative items, participants (N = 14) liked the intervention and agreed mindfulness skills would help manage disease-related distress. Following the interventions, participants reported increased mindfulness (p = .005). While preliminary, these results provide support for the continued development of evidence-based, mindfulness-oriented services to help individuals with SCD manage pain and other psychological difficulties.