Feasibility, Acceptability and Modification of a Post-surgical Telehealth Mindfulness-Based Intervention to Enhance Recovery After Lumbar Spine Surgery: A Prospective Intervention Study.

Global advances in integrative medicine and health Pub Date : 2025-05-21 eCollection Date: 2025-01-01 DOI:10.1177/27536130251344843
Carrie E Brintz, Erin Connors Kelly, Geneva Polser, Bethany A Rhoten, Michelle Foote Pearce, Rogelio A Coronado, Roisin O'Donnell, Shannon Block, Amanda Priest, Rishabh Gupta, Sarah T Whitaker, Stephen Bruehl, Byron F Stephens, Amir M Abtahi, Jacob Schwarz, Scott L Zuckerman, Benjamin French, Kristin R Archer
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Abstract

Background: People who undergo lumbar spine surgery experience variable pain, disability, and quality of life outcomes. Mindfulness-based interventions (MBIs) are recommended for chronic low back pain and may be an effective approach for surgical patients.

Objectives: Evaluate the feasibility and acceptability of a telehealth MBI following lumbar spine surgery and refine the intervention for optimal delivery.

Methods: This was a prospective, mixed-methods, single-arm cohort study with measurements preoperatively and 2 weeks and 3 months postoperatively. Participants were adults undergoing lumbar spine surgery for a degenerative condition at an academic medical center. A telehealth MBI was delivered one-on-one within 4 weeks after surgery and consisted of 8 weekly sessions modeled after Mindfulness-Based Cognitive Therapy for Chronic Pain. Outcomes were feasibility (enrollment rate, retention, session attendance, homework completion), acceptability (intervention satisfaction questionnaire and exit interview); and pre- to 3-month postoperative improvements in patient-reported disability, pain, and psychosocial factors including depression, anxiety, pain catastrophizing, kinesiophobia, self-efficacy, perceived stress, and dispositional mindfulness.

Results: Fifteen participants who received a laminectomy (n = 3) or fusion with (n = 9)/without (n = 3) laminectomy initiated the MBI. Enrollment (35%) and retention (80%) rates were lower than hypothesized, but participants had high levels of session attendance (80% completed) and home practice (median = 95% days assigned). The MBI was perceived as highly acceptable on the satisfaction questionnaire and exit interviews. Most participants reported improvements at or above established minimal clinically important differences for disability and pain at 3 months postoperatively and improvements in most psychosocial factors. Themes from exit interviews informed future modifications to the intervention.

Conclusions: Delivery of an 8-session, one-on-one, telehealth MBI to patients after lumbar spine surgery is feasible and acceptable and patients perceive meaningful benefits to their surgical recovery from the MBI. Results support fully powered randomized controlled trials to determine longer-term post-surgical effects of the MBI.

一项前瞻性干预研究:术后远程医疗正念干预增强腰椎术后恢复的可行性、可接受性和修改性。
背景:接受腰椎手术的患者会经历不同程度的疼痛、残疾和生活质量。正念干预(MBIs)被推荐用于慢性腰痛,可能是手术患者的有效方法。目的:评估腰椎手术后远程医疗MBI的可行性和可接受性,并改进干预措施以实现最佳交付。方法:这是一项前瞻性,混合方法,单臂队列研究,术前和术后2周和3个月测量。参与者是在学术医疗中心接受腰椎退行性手术的成年人。远程医疗MBI在手术后4周内一对一进行,包括8周的会议,模仿基于正念的慢性疼痛认知疗法。结果包括可行性(入学率、留校率、课程出勤率、作业完成情况)、可接受性(干预满意度问卷和退出访谈);术后3个月前患者报告的残疾、疼痛和心理社会因素的改善,包括抑郁、焦虑、疼痛灾难、运动恐惧症、自我效能、感知压力和倾向正念。结果:15名接受椎板切除术(n = 3)或融合(n = 9)/不(n = 3)椎板切除术的参与者开始了MBI。注册率(35%)和保留率(80%)低于假设,但参与者有高水平的会话出勤率(80%完成)和家庭实践(中位数= 95%指定天数)。在满意度调查问卷和离职面谈中,MBI被认为是高度可接受的。大多数参与者报告说,术后3个月残疾和疼痛的改善达到或高于确定的最小临床重要差异,大多数社会心理因素也有所改善。离职面谈的主题为今后干预措施的修改提供了依据。结论:为腰椎手术后患者提供8期一对一远程医疗MBI是可行和可接受的,患者认为MBI对他们的手术恢复有意义。结果支持完全随机对照试验,以确定MBI的长期术后效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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