Beyond the Patient: How Mindfulness can be Supportive to Patient Caregivers

As healthcare professionals, our care for people extends beyond the individual patient sitting before us. This is particularly true when treating patients undergoing cognitive decline who rely heavily on caregivers around them for support. Family caregivers often face substantial challenges adjusting to a new role managing the health of their loved one. So, what can we offer to patient caregivers to ensure that our patients are best supported?

A study published over the past week out of Hong Kong Polytechnic University School of Nursing sought to determine whether a modified Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) program was acceptable amongst caregivers of dementia patients. They also reported preliminary efficacy. Fifty-seven primary caregivers were recruited from the community and randomized to receive either modified MBSR or MBCT and they received in person instruction for seven sessions over 16 weeks. This was done via convenience sampling – all participants were recruited from two elderly centers in Hong Kong. 

Feasibility is an important metric for any potential intervention in medicine. In this study, they evaluated feasibility based on attendance and attrition of participants. They concluded that both interventions were feasible considering a high attendance (70%) and low attrition (<4%) rate. Importantly, both the MBSR and MBCT programs were modified slightly in order to make them more accessible. For example, sessions were combined, and follow-up was done over the phone in order to reduce the number of times participants need to come in for a session. These changes take into account the reality faced by the study cohort of primary caregivers – they are often stretched thin with their obligations to caring for someone and any intervention will need to accommodate for this. Interventions for caregivers need to be effective and not overly time consuming. 

The effectiveness of the intervention was studied secondarily to feasibility, but the results were encouraging. Amongst participants in both groups, perceived stress, depressive symptoms and subjective caregiver burden decreased significantly over the study period. Although both interventions were comparable, the modified MBCT had a greater impact on stress levels when compared to MBSR.  

This study opens the door to further research into how mindfulness could be of benefit to our patients, indirectly. Although these results are promising, much more needs to be done to definitely show that mindfulness is suitable (beyond feasibility) for primary caregivers. Based on the study design, it is impossible to conclude whether the positive effects seen amongst the intervention were mediated by the mindfulness-based intervention alone or other factors. Stay tuned for more research in this area – we may be able to offer much more to our patient’s caregivers down the line!

Reference:
(1) Cheung DS, Kor PP, Jones C, Davies N, Moyle W, Chien WT, Yip AL, Chambers S, Yu CT, Lai C. The use of modified Mindfulness-based Stress Reduction and Mindfulness-based Cognitive Therapy programme for family caregivers of people living with dementia: a feasibility study. Asian Nursing Research. 2020 Sep 12.