Chronic pain can be a significant burden on patients having various health disparities, including cancer and neurological disorders. In this paper, chronic pain will be defined as the symptoms that last for longer than three months or exceed the standard period for tissue healing (Hilton et al., 2016). The problem of this study is the feasibility of using mindfulness meditation-based interventions in controlling the symptoms of chronic pain. Within the research, the feasibility of this approach will be compared to the outcomes of traditional treatment methods, such as opioids. The purpose of this review is to analyze the following question: In patients experiencing chronic pain (P), how feasible is the use of mindfulness meditation-based interventions (I), compared to traditional treatment methods (C) in controlling the symptoms of pain?
The topic study is significant because it is vital to find additional ways of reducing chronic pain in patients. The background of the problem is that currently, strong opioids are primarily used to minimize the symptoms of chronic conditions. However, they can have adverse effects on individuals’ health and are costly (Ngamkham, Holden, & Smith, 2019). One of the alternative methods of pain relief is mindfulness meditation. Such an approach has been used for treating chronic pain for several decades, often as a supporting measure along with opioids (Zgierska, Ircink, Burzinski, & Mundt, 2017). During meditation, patients can pay attention to their breath, relax their muscles, and enhance their awareness of mind and body. This paper argues that the mindfulness meditation-based approach can be effective in reducing chronic pain.
Methods
The sources for this literature review were selected from peer-reviewed journals. They include Annals of Behavioral Medicine, Pain Medicine, Journal of Holistic Nursing, Journal of Opioid Management, Japan Journal of Nursing Science, and Asia-Pacific Journal of Oncology Nursing. The databases that were used for the research include PubMed, JSTOR, BioMed Central, and ScienceDirect. The keywords included mindfulness meditation, chronic pain, mindfulness meditation-based analgesia, effects of mindfulness meditation, meditation interventions. The inclusion criteria for the articles were: peer-reviewed, published within the past five years, and feature information about mindfulness meditation-based approaches to treating chronic pain. In addition, some materials were selected from nursing journals specifically to ensure the relevance of the question to the nursing practice. The exclusion criteria included being published in a non-peer-reviewed journal or being published more than five years ago. Two of the selected works present the first level of evidence, while the rest of them are systematic reviews. Seven peer-reviewed articles were selected; four of them were obtained from nursing journals.
Results
The first article selected for the literature review is the one by Chan and Larson (2015). In their work, the authors discuss the impact of meditation on chronic disease symptoms. The purpose of this study is to identify the most effective combination of meditation interventions to treat chronic pain and other conditions associated with chronic diseases, including anxiety and depression (Chan & Larson, 2015). The method of data collection used for research is the systematic review of 45 research studies. The primary findings of the study are that meditations can reduce chronic pain in patients with various conditions, including peripheral neuropathy, fibromyalgia, and headache (Chan & Larson, 2015). The primary strength of this study is that analyzes how mindfulness interventions can be applied for managing pain associated with conditions caused by different reasons. The main disadvantage is that it is not an original study but a summary of the existing body of literature on the topic.
The second article is by Hilton et al. (2016); the authors use the methods of a systematic review and a meta-analysis. The purpose of the study is to synthesize the evidence on the effectiveness of mindfulness meditation interventions used as treatment methods for chronic pain. The data for the analysis are collected through the systematic review of 38 randomized controlled trials and evaluated using the Hartung-Knapp-Sidik-Jonkman method for random-effects models (Hilton et al., 2016). The most significant finding of the paper is that mindfulness meditations can have a positive effect on improving pain symptoms; however, their impact compared to traditional treatment is small. At the same time, mindfulness interventions can reduce other symptoms of chronic conditions dramatically, including depression. The main strengths of the study are duplicate study selection and bias assessment. Its main disadvantage is the high percentage of poor-quality studies reviewed.
The third selected study is the one by La Cour and Petersen (2015); it represents a randomized controlled clinical trial. The purpose of the research is to evaluate the impact of mindfulness meditation on chronic pain. The findings reveal that mindfulness interventions had a significant positive impact on patients with long-lasting pain, showing a medium effect size immediately after treatment (La Cour & Petersen, 2015). The effect is still present with a non-significant decrease after six months. The primary strength of the study is that it provides the first level of evidence. Its potential weakness is that the authors do not consider the natural nonspecific improvements in patients’ conditions.
The fourth work is by Ngamkham et al. (2019); it uses the method of the integrative literature review. The study’s purpose is to analyze the effectiveness of mindfulness interventions on pain management and describe the underlying pathophysiologic mechanisms. The authors show that such an approach is useful because it moderates individuals’ emotional appraisal of their symptoms and withdraws their attention from pain (Ngamkham et al., 2019). The study’s primary strength is that it evaluates the level of bias in selected studies; its weakness is that it analyzes a small number of works.
The next study is by Takai, Yamamoto‐Mitani, Abe, and Suzuki (2015). Its purpose is to analyze possible nursing strategies aimed at reducing chronic pain, including those associated with meditation, by using the systematic review method. The findings of the research show that non-medications-based multidisciplinary pain management interventions decrease pain intensity significantly; however, they do not show long-term effectiveness (Takai et al., 2015). The study’s primary strength is that it provides implications for nursing practice; its limitation is that it does not consider long-term trends in pain management using mindfulness approaches.
The sixth work is by Williams, Simmons, and Tanabe (2015). The authors use a systematic review to identify how nurses can incorporate mindfulness interventions and the effectiveness of such an approach. The study reveals that can reduce chronic pain by more than 30%, minimizing its intensity, and improve patients’ acceptance of their symptoms (Williams et al., 2015). The primary strength of the study is that it provides information on how mindfulness meditation can be used in clinical practice. Its limitation is that the authors do not compare such an approach to traditional treatment methods.
The last selected study is by Zgierska et al. (2017). It presents the randomized controlled trial and aims at comparing the outcomes of mindfulness meditation used alone or as a support measure to traditional treatment to the results of usual care only. The findings show that meditation can reduce the severity of pain and pain sensitivity in patients while being a cost-effective approach (Zgierska et al., 2017). The work’s strength is that it provides the first level of evidence; its potential limitation is that the follow-up duration is short and the sample size is relatively small.
Discussion
The findings of the literature review show that mindfulness meditation-based methods can have a significant positive effect on managing chronic pain in patients. Selected works reveal consensus on the topic, confirming that such interventions can relieve pain immediately regardless of the condition an individual has (La Cour & Petersen, 2015; Chan & Larson, 2015). In addition, studies reveal that such an approach can change individuals’ attitudes towards their symptoms, withdraw patients’ attention from pain, and help them to accept it (Williams et al., 2015; Ngamkham et al., 2019). However, the authors disagree on the longevity of the positive impact of meditation; some of them note that its effectiveness compared to traditional methods is small (Hilton et al., 2016). The primary strength of the research area is that much evidence on the topic is available. The evidence includes the findings of randomized control trials, which shows that the results are reliable. The potential weakness of the research area is that few studies are comparing the effects of mindfulness meditation-based interventions and traditional pain relief methods.
Conclusion
The literature review answers the research question and shows that the implementation of mindfulness meditation-based intervention is feasible for reducing chronic pain. The findings of the studies show that such an approach can minimize the symptoms and change patients’ perspectives towards them significantly. The recommendation that can be drawn from the literature review is that nurses should use holistic approaches, including meditation, in addition to traditional ones to manage individuals’ symptoms.
References
Chan, R. R., & Larson, J. L. (2015). Meditation interventions for chronic disease populations: A systematic review. Journal of Holistic Nursing, 33(4), 351-365.
Hilton, L., Hempel, S., Ewing, B. A., Apaydin, E., Xenakis, L., Newberry, S.,… Maglione, M. A. (2016). Mindfulness meditation for chronic pain: Systematic review and meta-analysis. Annals of Behavioral Medicine, 51(2), 199-213.
La Cour, P., & Petersen, M. (2015). Effects of mindfulness meditation on chronic pain: A randomized controlled trial. Pain Medicine, 16(4), 641-652.
Ngamkham, S., Holden, J. E., & Smith, E. L. (2019). A systematic review: Mindfulness intervention for cancer-related pain. Asia-Pacific Journal of Oncology Nursing, 6(2), 161-169.
Takai, Y., Yamamoto‐Mitani, N., Abe, Y., & Suzuki, M. (2015). Literature review of pain management for people with chronic pain. Japan Journal of Nursing Science, 12(3), 167-183.
Williams, H., Simmons, L. A., & Tanabe, P. (2015). Mindfulness-based stress reduction in advanced nursing practice: A nonpharmacologic approach to health promotion, chronic disease management, and symptom control. Journal of Holistic Nursing, 33(3), 247-259.
Zgierska, A. E., Ircink, J., Burzinski, C. A., & Mundt, M. P. (2017). Cost of opioid-treated chronic low back pain: Findings from a pilot randomized controlled trial of mindfulness meditation-based intervention. Journal of Opioid Management, 13(3), 169-181.