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A randomized, controlled pilot study of mindfulness-based stress reduction for pediatric chronic pain. Altern Ther Health Med 2013;19(6):8-14

Date

11/21/2013

Pubmed ID

24254033

Scopus ID

2-s2.0-84888119051 (requires institutional sign-in at Scopus site)   53 Citations

Abstract

CONTEXT: It is estimated that 1 in 5 children in the United States is affected by chronic pain. Increasing adaptive coping strategies and decreasing stress may be important in treatment. Research has suggested that mindfulness can help alleviate symptoms associated with medical illnesses and increase quality of life. Little is known about the effectiveness of mindfulness-based stress reduction (MBSR) in youth, partly due to insufficient methodological rigor in related studies.

OBJECTIVE: The primary purpose of the present study was to examine the feasibility, acceptability, and effectiveness of MBSR for a treatment-seeking sample of youth with chronic pain.

DESIGN: The current study was the first randomized, controlled pilot study of MBSR for pediatric chronic pain. The research team had intended to use block randomization involving a total of five recruitment waves, with each wave consisting of one MBSR group and one psychoeducation group. Due to difficulties with recruitment and attrition before the start of either group, however, only MBSR was conducted at each wave after the first wave.

SETTING: Participants were recruited from a multidisciplinary pain clinic in a large, Midwestern children's hospital.

PARTICIPANTS: The final sample included six adolescents between the ages of 12 and 17 y, four in the MBSR group and two in the psychoeducation group.

INTERVENTION: Weekly sessions for the MBSR group were 90 min in length and followed a structured protocol. Sessions included a review of homework, an introduction to and practice of meditation, discussion of the session, and a review of the home practice assignment. The psychoeducation group participated in six group sessions, which were based on a cognitive-behavioral model of pain, and discussion topics included the nature of chronic pain and stress management.

PRIMARY OUTCOME MEASURES: Health-related quality of life, pain catastrophizing, anxiety, functional disability, mindfulness, and treatment acceptability were all assessed pre- and postintervention as well as at follow-up.

RESULTS: Recruitment and retention difficulties were experienced. Qualitative examination of participants' scores suggested increased mindfulness but inconsistent patterns on other outcome measures.

CONCLUSIONS: The research team highlighted critical challenges faced by potential researchers aiming to investigate MBSR for pediatric chronic pain, and the study provides recommendations for research and implications for clinical practice.

Author List

Jastrowski Mano KE, Salamon KS, Hainsworth KR, Anderson Khan KJ, Ladwig RJ, Davies WH, Weisman SJ

Authors

Kimberly J. Anderson Khan PsyD Associate Professor in the Anesthesiology department at Medical College of Wisconsin
W. Hobart Davies Professor & Chair in the Phychology department at University of Wisconsin - Milwaukee
Keri Hainsworth PhD Director, Associate Professor in the Anesthesiology department at Medical College of Wisconsin
Steven J. Weisman MD Professor in the Anesthesiology department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adolescent
Child
Chronic Pain
Female
Hospitals, Pediatric
Humans
Male
Mind-Body Therapies
Mindfulness
Pain Measurement
Pilot Projects
Stress, Psychological