Mindfulness is defined in a traditional context as the state where ones presence of mind is concerned with a clear awareness of the persons inner and outer experiences like sensations, emotions, thoughts, actions and the surrounding as they all are at the moment (Gotink et al., 2015). From a scientific perspective, mindfulness should display core components such as the presence of total attention to external and internal experiences at the moment as they occur. According to (Henry, 2017), one should have an attitude that is free from judgment and is open the current experience. Mindfulness has been adopted in the healthcare as a management and treatment intervention. (Bisseling et al., 2018) Argues that even with the failure to meet some scientific requirement for treatment methods, mindfulness has been noted to significantly improve state of depression and anxiety. In the recent past, researchers have developed a modern standardized version of mindfulness intervention that is applied in the western healthcare system (Labelle, Campbell and Carlson, 2010). Previously there has been development and integration of mindfulness into the treatment program. In 1979, the Mindfulness-Based Stress Reduction was created as a model for working with patients who were suffering from stress (Blustein, 2015). The model was applied to other illnesses and proved that changing how patients conceptualize pain helped change their experience of pain. Teasdale, William, and Segel enhanced the model and named it Mindfulness-Based Cognitive Therapy. The new model recorded a 50% decrease for patients who had three or more active episodes of depression. Scientific studies confirm benefits of using mindfulness to manage patients with chronic illnesses including depression, anxiety, breast cancer, coronary heart disease and asthma.
Chronic illness has been statistically credited to cause 63% of all deaths (Lam et al., 2017). Research indicates that chronic illness has no cure and medical attention can only provide means of managing the illness. However, patients suffering from chronic illness go through a high burden progressing from symptoms, management procedures and side effects of taken treatment like radiotherapy for cancer. Even with the need to focus on finding a cure for chronic illness, doctors and researchers appreciate the need to provide quality chronic care to patients and teach them mechanisms that would help to improve the quality of life (Bondolfi, 2013). The logic behind providing quality care for patients with chronic illnesses is to hence humane experience as one receives treatment. According to (Lam et al., 2017), the experiences that patients with chronic illness go through can be very traumatizing such that they develop other conditions that further deteriorate their already weak health status. Such conditions include stress, anxiety, and depression.
Methods of Literature Search
Articles used for this research were obtained from medical sources with few obtained from other healthcare fields. Articles were reviewed and assessed on credibility to be used for this paper from sources like MEDLINE, MESH, PUBMED, and NCBI. The sources were approved for use if they contained information on the application of the mindfulness-based stress reduction- a model for application of mindfulness- to chronic illness including breast cancer, coronary heart disease, asthma and rheumatoid arthritis.
Using Mindfulness-Based Stress Reduction (MBSR) In Chronic Illness.
Mindfulness-based stress reduction therapy is an application model that uses mindfulness and meditation. The model was designed for stress management but has been found to work on chronic illness.
There is a gap in knowledge concerning the use of MBSR in the treatment of chronic illnesses. However, studies show a significant decrease in anxiety, depression and stress symptoms commonly found among patients with chronic illness like breast cancer (Weitz, Fisher and Lachman, 2012). The model has also been noted to have significant improvement in the quality of life. According to (Niazi and Niazi, 2011), a study involving 14 patients investigated the effectiveness of MBSR measure blood pressure, psychological symptoms, body weight and general psychological distress. The study found that the model was useful in decreasing, anxiety, depression, and psychological distress.
(Ardebil and Banth, 2015) Conducted a study to evaluate the relationship between MBSR and depression among patients with rheumatoid arthritis. MBSR was introduced as a component of the treatment regimen to one group, and another group was given treatment excluding MBSR. The report published in annual rheumatic diseases included 73 patients who participated in ten groups and attended sessions for 15 weeks. For the group whose treatment included MBSR, there was a decrease in reported symptoms, and there was no significant change in the group that received the usual treatment.
Mindfulness has been noted to be useful in pain management. In another study by (Thomas and Garland, 2017) the researchers tested the effectiveness of MBSR in pain management and psychological distress across populations suffering from various chronic illnesses including arthritis. The exercise program included 133 patients. The findings indicated a significant improvement in the experience of pain and physical function. According to (Curtin and Norris, 2017), most patients reported further improvements when they practiced at home too.
The article by (Bisseling et al., 2018), reports a study that investigated the impact of MBRS on a female population with breast cancer. Sixty-four women participated, and among them, fifty-two, who completed questionnaires reported improvement in psychological distress. Another study by (Niazi and Niazi, 2018) reported that emotional readiness is an important factor that affected ones responsiveness to MBSR program. The study indicated a decrease in chronic depression with fewer reported recurrences of active episodes during the program. The findings in the work of (Dobkin and Matousek, 2010) emphasize the need to inform patients of MBSR early as it helps to strengthen a patients autonomy and self-management skills.
Coronary heart disease
In their study, (Parswani, Sharma and Iyengar, 2018) focused on examining the effect that MBSR had on symptoms like anxiety perceived stress, depression, blood pressure and body mass index in patients who had coronary heart disease. The study included thirty male patients between the ages of 30-65 years. The MBSR program lasted for eight sessions held weekly. Normal treatment procedure was also observed. The results obtained indicated a significant decrease in anxiety, blood pressure, BMI and depression among patients who completed the program. Another study by (Gu and Zhu, 2017) showed a significant increase in levels of mindfulness and positivity. There was a significant change in mood state to relatively positive mood states.
Asthma is a chronic respiratory condition that affects the health and quality of life of the patient (M et al., 2018). According to (Haines et al., 2015), most people with asthma suffer from anxiety. The use of psychological interventions together with standardized treatment help in the reduction of anxiety and improve lung functioning among the patients. Mindfulness is known to reduce anxiety among people across all age groups and most effective in children and adolescents. A study by (M et al., 2018) carried out among patients who have asthma and under MBSR therapy found that there was a significant reduction in anxiety and lung function. There was a significant improvement in lung function especially during the day during and after sessions.
Critique of Mindfulness-Based Stress Reduction in The Management of Chronic Illness.
Much of the research available measures the effectiveness of mindfulness when working with patients with chronic illnesses. The MBSR model has been proven to be an effective component of treatment and management of various chronic illness. Further study on the models is needed and is limited by faulty study designs, methods, and biased analyses. The application of the mindfulness when working with patients may differ significantly from one situation, diseases or professional to the other. According to (Maldonado Fernandez, Rubio Rodriguez and Lopez Fernandez, 2016), there is need to conduct further research to reveal how mindfulness facilitates the improvement of symptoms. Having such knowledge will help professional to device better application mechanisms of the models like MBSR. Mindfulness and most models derived from its concepts, for example, MBSR have not been standardized as a component of medical treatment and hence even though proven useful in most studies (Bondolfi, 2013). Therefore, there may need to give patients an option to choose or reject MBSR in their treatment.
Summary and Conclusions
Mindfulness involves one being aware of the internal and external experience happening in their environment at the time. Studies have embraced the use of mindfulness as a component for treatment of chronic diseases (Ortho.wisc.edu, 2018). Models like MBSR have been structured to provide an application guideline for using mindfulness. The use of mindfulness has been noted to improve the experience of pain, depression, anxiety and psychological distress among patients with breast cancer, coronary heart disease, asthma and rheumatic arthritis. Further studies are needed to inform more on the application of mindfulness. Although the use of mindfulness is helpful for patients with chronic diseases, it has not been accepted as a standard treatment in medicine and hence the need to get patients' consent before enrolling them in the treatment.
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