The Analgesic Effects of Nurse-Led, Ultra-Brief Mindfulness Interventions: A Randomized Controlled Trial

ObjectiveMindfulness-basedinterventions have been shown to improve total joint arthroplasty patient outcomes. However, traditional mindfulness-based interventions are not always accessible to total joint arthroplasty patients and they use many different styles of mindfulness practice. Thus, critical steps in improving total joint arthroplasty patient outcomes include (1) improving accessibility to mindfulness-based interventions and (2) identifying the most effective style of mindfulness practice for total joint arthroplasty patients.MethodWe conducted a single site, three-arm, randomized clinical trial to evaluate the effects of two different nurse-led, ultra-brief (i.e., 3-min), mindfulness-based interventions on total joint arthroplasty patients' (n = 127) preoperative (i.e., pain intensity, pain unpleasantness, and pain medication desire) and postoperative (physical function) outcomes. Participants were randomly assigned to either a standard, preoperative nurse consultation, a preoperative nurse consultation that included a 3-min mindfulness of breath practice, or a preoperative nurse consultation that included a 3-min mindfulness of pain practice.ResultsThe mindfulness of breath and mindfulness of pain practices resulted in less pain intensity (Breath: -0.69, p = 0.006; Pain: -0.57, p = 0.010) and pain unpleasantness (Breath: -0.94, p = 0.001; Pain: -0.62, p = 0.026) relative to the standard nurse consultation. Additionally, the mindfulness of pain practice resulted in less pain medication desire relative to the mindfulness of breath practice (-0.92, p = 0.011) and standard nurse consultation (-1.12, p = 0.002). No effect was observed on postoperative physical function.ConclusionEmbedding nurse-led, ultra-brief, mindfulness-based interventions in total joint arthroplasty patients' surgical care pathways appears to be an effective nonpharmacological pain management strategy.PreregistrationClinicalTrials.gov NCT04800354.