Effects of Mindfulness-Based Interventions on Symptoms Among Patients With Medically Unexplained Physical Symptoms

Monday, 30 October 2017

Nada Lukkahatai, PhD, MSN1
John Davis Barcelo2
Teodora Naydenova2
(1)School of Nursing, University of Nevada, Las Vegas, Las Vegas, NV, USA
(2)School of Nursing, University of Nevada Las Vegas, Las Vegas, NV, USA

Background: Medically unexplained physical symptoms (MUPS) are prolonged inconsistent physical symptoms with no pathology. Mindfulness based interventions (MBIs) are believed to decrease physical distress symptoms by balancing sympathetic and parasympathetic responses to meditation exercise using slow and deep breathing. These interventions currently are recommended for symptoms management in MUPS patients.

Objectives: This study aims systematically review the state of science on the effects of MBI on symptoms experienced by patients with MUPS.

Methods: A systematic review was conducted on the following databases PubMed, Web of Science, Scopus, EMBASE, and PsycINFO using the search terms of “mindfulness” or “meditation” and “medically unexplained symptoms” or “medically unexplained physical symptoms.” The inclusion criteria of completed clinical trial study, participants age older than 19, “English” language were used. Studies in patients with psychological disorders, instrument development, and feasibility studies were excluded. The Oxford quality scoring system was used for quality evaluation.

Results: After excluded duplicate, 1,065 articles were identified. Twenty four studies were selected. Nine studies were published within 2014-2016. Then studies (42%) was done in the US. The majority studies investigated effects of MBI on symptoms in white women (%), diagnosed with irritable bowel syndrome (50%) with a mean age range from 32.0-54.4 year old. There is twenty face to face interventions and four online interventions. The majority of studies delivered the intervention in group of 4 to 8 people. The sessions were approximately two and a half to seven hours and about two to eight weeks each. Studies reported significant improvement of fatigue (3 of 4 studies) and depression (6 of 9 studies). Only 42% of studies showed significant improvement in pain (5 of 12 studies). Most studies suggested that these improvements were not sustained. The most often limitations are the lack of randomization and lack of control group.

Conclusion: Evidence supports the benefits of MBIs on the symptoms experienced by patients with MUS. This intervention can be used as one of the alternative nursing intervention for patients suffering from pain, fatigue, and depression. However, future studies should develop a durable MBIs for patients with MUPS.