JMIR Publications

ABSTRACT

Background:

Mindfulness-based interventions have been used for psychological care for people with various physical illnesses. However, no program has been established for individuals with pulmonary hypertension (PH).

Objective:

This study developed and assessed the feasibility of a mindfulness-based self-management program designed to improve the quality of life (QOL) among patients with PH and to reduce their depression and anxiety. Considering the limited mobility of patients with PH, we adopted an online format.

Methods:

We conducted a single-arm, pre–post design study. We implemented an eight-session weekly videoconference group program that comprised education of self-management on PH and elements of Mindfulness-based cognitive therapy. A mobile application using the Apple Watch was integrated into the program to facilitate symptom monitoring and awareness from mindfulness. We assessed PH-related symptoms, QOL (the emPHasis-10), and depression (PHQ-9), anxiety (GAD-7), resilience (CD-RISC), and loneliness(UCLA Loneliness Scale-short version) at baseline, after four weeks, and upon program completion. We conducted an exit interview to explore the changes, insights, and lessons learned through the program.

Results:

Twelve participants with the mean age of 41.8 ± 10.5 years (range: 26–56 years) were enrolled. Nine of them completed the program (75% retention rate). Participants valued the online format and the integration of the Apple Watch. They expressed a need for additional on-demand sessions. Qualitative analysis identified 10 key themes, including increased self-awareness, pain management through meditation, and self-compassion. Quantitative analysis revealed no significant differences in changes among the four time points (baseline, 4 weeks, 8 weeks, and 12 weeks; n = 5). However, significant differences were observed at three time points (baseline, 4 weeks, and 8 weeks) on emPHasis-10 (χ²(2) = 9.742, P = .008) and CD-RISC (χ²(2) = 7.267, P = .03; n = 8). In addition, although no significant difference was found, a trend toward change in the PHQ-9 (χ²(2) = 4.750, P = .09) and GAD-7 (χ²(2) = 5.067, P = .08) was observed. No significant changes in loneliness were observed.

Conclusions:

The program helped patients with PH manage their symptoms and emotions as well as the adverse effects of the treatments, thereby improving their QOL. A future efficacy trial is warranted. Clinical Trial: This study registered in UMIN Clinical Trials Registry (UMIN000044075).