Mindfulness meditation improves quality of life in heart attack survivors

USING THIS IN ALBERTA FOR STROKE PATIENTS

EUROPEAN SOCIETY OF CARDIOLOGY

Research News

An eight-week programme of mindfulness meditation improves quality of life and reduces fear of activity in heart attack patients, according to research presented today at ESC Acute CardioVascular Care 2021, an online scientific congress of the European Society of Cardiology (ESC).1

"A heart attack is a serious life-threatening event and survivors can suffer from low quality of life," said study author Dr. Canan Karadas of Hacettepe University, Ankara, Turkey. "One reason is a fear of movement, called kinesiophobia, which limits daily activity due to concerns of another heart attack."

"Mindfulness refers to the mental state achieved by focusing awareness on the present moment, including thoughts, feelings, and physical sensations," continued Dr. Karadas. "It has drawn increasing attention for treating chronic conditions such as high blood pressure. Our study examined its effect on fatigue, kinesiophobia, and quality of life after an acute myocardial infarction."

The study included 56 patients who had experienced a heart attack. The average age at enrolment was 55 years. Participants were randomly assigned to a mindfulness or control group for eight weeks. Patients in the control group attended one 15-minute individual education session on the structure and function of the heart, the coronary arteries, and diseases of the heart.

Patients assigned to the mindfulness intervention attended an individual session which included a 15-minute description of the technique. This was followed by 15 minutes of supervised practice: patients were asked to sit comfortably on a chair with their backs straight and eyes closed. They were then instructed to breathe deeply - inhaling through the nose and exhaling through the mouth using the diaphragm - and focus on their breathing and the present moment. Participants received a recording of the instructions via WhatsApp and were asked to repeat the 15-minute session every day at home in a quiet room. Daily reminders (text messages or phone calls) were used to motivate patients to practice the meditation and to evaluate their compliance with the study protocol.

Fatigue, kinesiophobia, and quality of life were assessed at baseline and weeks four, eight and 12 using the Piper Fatigue Scale, Tampa Scale for Kinesiophobia Heart questionnaire, and MacNew Heart Disease Health-Related Quality of Life questionnaire which examines patients' feelings about how their heart condition affects daily function overall and in three areas (physically, emotionally, and socially).

At baseline, there were no differences in the three variables between the intervention and control groups. By week four, patients in the mindfulness group had less fear of movement compared to the control group - a benefit that was sustained at weeks eight and 12. Patients in the mindfulness group had better quality of life overall and in all three areas than those in the control group at week eight, while at week 12 they continued to report better emotional function. Measurements of fatigue did not vary between the two groups at any time point.

Dr. Karadas noted that participants only reported mild fatigue at the beginning of the study which may explain why meditation did not have any impact.

She said: "Our study shows that mindfulness can reduce fear of movement and improve quality of life in heart attack survivors, with effects extending beyond the completion of the intervention. One explanation may be that meditation replaces catastrophic thinking with positive thoughts, making patients feel less emotionally and physically vulnerable. The findings suggest that mindfulness may be considered in the rehabilitation of patients after a heart attack. These results are very encouraging but more studies are needed to confirm our findings."

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Notes to editor

Funding: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Disclosures: The authors declare that there is no conflict of interest.

References and notes

1Abstract title: Effects of daily mindfulness practice on fatigue, kinesiophobia, and quality of life in patients with acute myocardial infarction: a randomized controlled trial.

About the Association for Acute CardioVascular Care

The Association for Acute CardioVascular Care (ACVC) is a branch of the ESC. Its mission is to improve the quality of care and outcomes of patients with acute cardiovascular disease.

About ESC Acute CardioVascular Care Congress 2021 #ACVC2021

ESC Acute CardioVascular Care Congress 2021 is the online annual congress of the Association for Acute CardioVascular Care of the ESC.

About the European Society of Cardiology

The European Society of Cardiology brings together health care professionals from more than 150 countries, working to advance cardiovascular medicine and help people lead longer, healthier lives.

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Mindfulness program in campus dorms, groups improved students' mental health

UNIVERSITY OF WASHINGTON

Research News

 

As experts nationwide point to a mental health crisis among teens and young adults, a pilot program teaching mindfulness and coping techniques to students at the University of Washington has helped lower stress and improve emotional well-being.

New studies by the psychology researchers who created the program find that the strategies, offered first in residence halls and later through classes and other organized campus groups, have provided participants with successful methods for coping with stress, managing their emotions and learning self-compassion.

Researchers say the results show the potential for preventive mental health services offered in an accessible, peer-group environment.

"This program is not a substitute for campus mental health services for students. But with a preventive program, our goal is to reduce general distress in college students and hopefully prevent need for increased or more intensive services," said Liliana Lengua, psychology professor and director of the Center for Child and Family Well-Being at the UW.

Recent studies of the program's rollout point to its success. Results from the program's first year, when it was offered in 2017-2018 in residence halls on the UW's Seattle campus, were published March 10 in Anxiety, Stress & Coping. Results of its second year, provided during the 2019-2020 academic year by trained university staff in campus settings such as classes and student organizations, were published Feb. 12 in Frontiers in Psychiatry. Student participants reported significant improvements in their psychological well-being that lasted three months after the sessions ended.

During the pandemic -- with millions of young people studying remotely -- the importance of teen and college student mental health has grown. According to the CDC, 1 in 4 young adults between the ages of 18 and 24 has considered suicide in the past year, while separate studies of college students in recent months have found more than 70% report serious distress.

But even before the pandemic, campuses nationwide were reporting high levels of student stress and anxiety, with college mental health directors noting need for services that far outpaced availability. Academic demands, financial pressures, social tumult and, especially among first-year students, the transition to campus life all affect student mental health.

Against this backdrop, the authors decided to come up with a short intervention at the UW that would provide real-world coping strategies in an environment that students could access easily -- without an appointment or any fee, in the casual atmosphere of a group, and where they already live, study or socialize. The program, called Be REAL, or Resilient Attitudes and Living, combined traditional cognitive behavioral coping strategies -- such as planning, positive reframing and acceptance -- with mindfulness practices focused on regulating breathing, meditation and accessing feelings of compassion, tolerance and gratitude toward oneself and others. By having staff who are already working with student in various settings offer the program, it can potentially reach more students.

"The idea behind Be REAL was to have a new model to promote student well-being and mental health. Traditional counseling systems are unlikely to keep pace with demand, so we wanted to think of a program that could be delivered more broadly by nonclinical staff members," said Robyn Long, director of community programs and training for the Center for Child and Family Well-Being.

The first year, 208 students signed up for the program across three academic quarters. Facilitators trained in mindfulness techniques led six evening sessions at four residence halls. Among the more than 80% of students who attended the majority of the sessions, results from pre- and post-surveys showed significant improvements in mindfulness and self-compassion, greater resilience and lower stress. These findings held steady in a three-month follow-up survey of participants.

Those results led to the expansion of the program to other campus settings, with associated university staff -- from the recreation department, for example, as well as those connected to student organizations -- voluntarily trained in the Be REAL program. This approach aimed to reach additional students, particularly those from underrepresented groups, in spaces they already frequent. Of the 271 students who enrolled in Be REAL programming, 116 agreed to participate in the study; more than half were students of color.

Researchers found results that were similar to the residence hall study, especially regarding stress and emotional regulation. In their comments on post-study surveys, students reported using meditation and breathing techniques to help focus or calm down, and developing habits to handle stress.

The results raised other issues that researchers are exploring further, such as whether providing the lessons in a class that students take for credit creates more of a perceived burden -- and thus, leaves less of an impact -- than sessions in which students simply choose to participate.

A new, ongoing study is examining how about 100 university staff from all three UW campuses, trained in offering the program remotely, along with still more students, respond to the techniques for improving mental health. Those results may suggest opportunities for students and staff alike to benefit from the strategies in a range of environments, on any college campus, and to possibly change a campus culture around supporting student well-being. The Center for Child and Family Well-Being is collaborating with the UW Resilience Lab to expand the program and facilitator training to staff.

"Expanding Be REAL to promote staff well-being and training is important because their work, especially with the pandemic, can be stressful," Long said. "They've even shared how the practices are shifting their interactions with children and loved ones at home. Our expansion of the program goes beyond individual well-being -- it's also about strengthening our community on campus."

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Both published studies were funded by the Maritz Family Foundation. Max Halvorson, a doctoral student in the UW Department of Psychology, was a co-author of the study published in Anxiety, Stress & Coping. Co-authors of the study published in Frontiers in Psychiatry were Katie Malloy Spink, research coordinator for the Center for Child & Family Well-Being, and Megan Kennedy, director of the UW Resilience Lab.

For more information, contact Lengua at liliana@uw.edu or Long at rblong2@uw.edu.