Effects of a mindfulness-based intervention on symptoms and signs in chronic heart failure: A feasibility study.
Jonna Norman, Michael Fu, Inger Ekman and 2 others
PMID 28639841WHAT IT FOUND
In 40 people with chronic heart failure, adding eight weeks of mindfulness training to usual care reduced self-reported fatigue compared with usual care alone.
Sleep, walking distance, heart rate and breathing rate did not differ between groups.
Key findings
01The mindfulness group had a median change in the fatigue sum score of -8.0, compared with 0.0 in the usual care group, on a scale from 9 to 63.
02The mindfulness group also showed significantly greater improvement in self-reported unsteadiness/dizziness and NYHA class than the usual care group.
03There was no significant difference between groups in sleep quality, walking distance, heart rate or breathing rate.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a feasibility study, not a completed randomised trial; slow recruitment led to some openly assigned participants. Only 40 participants were analysed, with no power calculation, so the study cannot confirm an effect. The researchers could not be blinded to the mindfulness intervention, and self-reported outcomes may be influenced by expectations. Many patients declined or dropped out because they were too tired, too sick or unwilling to do the required practice, so results may apply only to motivated patients. Two dropouts were linked to mindfulness, including increased symptom awareness and gloomy mood, so patient safety and psychological support need consideration. The study was single-centre, short-term, and included stable outpatients, so it does not show what happens in more severe, unstable or diverse populations. The fatigue scale had not previously been tested in chronic heart failure, and some secondary outcomes had ceiling effects or low baseline disturbance.
Declared interests
The authors declared no conflicts of interest. The study was funded by the Centre for Person-Centred Care at the University of Gothenburg, which is supported by a Swedish Government strategic research grant.
The easy way to misread this
Do not conclude that mindfulness training is proven to improve chronic heart failure symptoms. This was a small, partly non-randomised feasibility study with no blinding, short follow-up, and several important outcomes were not significant.