Effects of mindfulness-based preoperative intervention for patients undergoing elective surgery: A meta-analysis

Kuang-Mou Tung; Yunjhen Su; Yi-No Kang; Wen-Hsuan Hou; Khanh Dinh Hoang; Kee-Hsin Chen; Chiehfeng Chen

doi:10.1016/j.jpsychores.2024.111666

Effects of mindfulness-based preoperative intervention for patients undergoing elective surgery: A meta-analysis

J Psychosom Res. 2024 Apr 13:181:111666. doi: 10.1016/j.jpsychores.2024.111666. Online ahead of print.

Authors

Kuang-Mou Tung¹, Yunjhen Su², Yi-No Kang³, Wen-Hsuan Hou⁴, Khanh Dinh Hoang⁵, Kee-Hsin Chen⁶, Chiehfeng Chen⁷

Affiliations

¹ School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan.
² School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Taichung Veterans General Hospital, Taichung, Taiwan.
³ Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan; Evidence-Based Medicine Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan.
⁴ Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
⁵ Hai Phong University of Medicine and Pharmacy, Department of Histopathology, Hai Phong, Viet Nam.
⁶ Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan; Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Department of Nursing, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Research Center in Nursing Clinical Practice, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Evidence-Based Knowledge Translation Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Selangor, Malaysia. Electronic address: keehsin@tmu.edu.tw.
⁷ Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan; Evidence-Based Medicine Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Division of Plastic Surgery, Department of Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. Electronic address: clifchen@tmu.edu.tw.

PMID: 38657565
DOI: 10.1016/j.jpsychores.2024.111666

Abstract

Objective: Patients often experience pain and psychological distress when undergoing elective surgeries. Mindfulness-based interventions have been proposed as potential strategies to address these challenges. This meta-analysis aims to evaluate the efficacy of preoperative mindfulness-based interventions on several outcomes for patients undergoing elective surgery, including preoperative anxiety/depression, postoperative anxiety/depression, postoperative pain, and quality of life (QOL).

Methods: This meta-analysis encompassed randomized controlled trials published in the database PubMed, Cochrane, and Embase to August 2023. Mindfulness-based interventions were compared to control groups, who received treatment as usual (TAU). The RevMan software was employed to assess each outcome by using standardized mean difference based on patient-reported data. Subgroup analyses were further performed according to different categories of surgical types.

Results: Eight RCTs with a total of 685 patients were identified. This meta-analysis demonstrated significant difference in preoperative anxiety (SMD:-0.36, 95% CI: -0.62 to -0.11, p = .006) and postoperative pain immediately (SMD:-0.65,95% CI: -1.09 to -0.20, p = .004), 2-3 days (SMD:-0.40, 95% CI:-0.78 to -0.02, p = .04),at 14 days (SMD:-0.48,95% CI: -0.85 to -0.12, p = .009) and 28 days (SMD:-0.89,95% CI: -1.55 to -0.23, p = .008) postoperatively. However, there were no differences between postoperative anxiety, preoperative/postoperative depression, and QOL.

Conclusion: Our findings suggest preoperative mindfulness-based interventions can effectively manage preoperative anxiety and postoperative pain in patients scheduled for elective surgery. Further research is warranted to explore the different timing and types of mindfulness-based intervention.

Keywords: Anxiety; Mindfulness; Pain; Perioperative care; Surgery.