Purpose: Our objective was to test the effect of a nurse-inspired 8-week mindfulness intervention on the overall symptom burden, inflammation, and impact on quality of life (QOL) in primary care adults with multiple sclerosis (MS).
Background and significance: Multiple sclerosis (MS) affects nearly one million people in the United States and more than two million worldwide. Symptoms may include fatigue, anxiety, depression, and motor/sensory issues. Mindfulness-based art therapy (MBAT) has been shown to provide a mindfulness-based intervention (MBI) for adults with MS to self-manage their symptoms. There is a need for the use of a nurse-inspired MBAT intervention that can be delivered in any setting as typical MBIs may be impaired by time and access to health care.
Methods: Participants with MS (n=16) were purposefully selected for the virtual MBAT pilot study. Participants were asked to complete the MS-related symptom scale (MS-RS) at baseline and 3 months and salivary cytokines for inflammation (IL-10), as well as PROMIS fatigue, global health for QOL, and Center for Epidemiological Studies (CES-D) for depression.
Results: A majority of participants were white, women (87.5%) with a mean age of 43.6 in years (SD=10.2). Most were married (62.5%), employed (81.3%), with relapsing-remitting MS (71.4%). PROMIS fatigue mean (58.8±8.4), global physical mean (43.8±6.9), global mental mean (43.5±7.7), CES-D mean (14.3±11.2), and PSQI mean (7.0±2.6) were reported before MBAT intervention. The mean MS-RS total score was 38.6 (SD=18.8) before and 27.6 (SD=9.6) after MBAT intervention (p=0.19). Considering the large proportion of missing values of MS-RS after MBAT intervention, we applied a multiple imputation method to impute the missing values assuming a multivariate normal distribution of MS-RS at the two time points. The estimated mean change of MS-RS (after - before) is -5.7±8.2 (p=0.017). The change of MS-RS is significantly correlated with global physical (r=0.78, p=0.001), global mental (r=0.55, p=0.04), CES-D (r=-0.61, p=0.036), and PSQI (r=-0.58, p=0.025) before intervention. IL-10 significantly correlated with motor, sensory, and mental subscales of the MS-RS symptom scale.
Conclusions and implications: A virtual nurse-inspired MBAT could be an effective strategy for the mitigation of overall MS symptoms. The preliminary pilot work proposed in this study has the expected outcome to advance clinical practice with patient-tailored interventions in the medical surgical setting.
This abstract is being submitted by an AMSN grant winner to meet the requirements of their grant to disseminate their findings. Evidence-based references 1. Newland et al. (2020). Effectiveness of mindfulness-based art therapy for symptoms of anxiety, depression, and fatigue: A systematic review and meta-analysis. Complementary therapies in clinical practice. https://doi.org/10.1016/j.ctcp.2020.101246 2. Newland et al. (2020). Pilot Study of Videos to Deliver Mindfulness-Based Art Therapy for Adults with Multiple Sclerosis. The Journal of neuroscience nursing: journal of the American Association of Neuroscience Nurses. https://doi.org/10.1097/JNN.0000000000000547