title: A pilot study of a mindfulness based stress reduction program in adolescents with implantable cardioverter defibrillators or pacemakers.
abstract: Adolescents with implantable cardioverter defibrillators (ICDs) or pacemakers (PMs) face unique challenges that can cause psychosocial distress. Psychosocial interventions are effective for adults with cardiac devices and could potentially impact adolescents' adjustment to these devices. Mindfulness Based Stress Reduction (MBSR) is a structured psycho-educational program that includes meditation, yoga, and group support and has been studied extensively among adults. This study examined the feasibility of the MBSR program for adolescents with ICDs/PMs, a population previously unexamined in the research literature. The participants completed measures of anxiety and depression (Hospital Anxiety and Depression Scale) and coping (Responses to Stress Questionnaire) at baseline and after the six-session MBSR intervention. Mean age of the cohort (n = 10) was 15 ± 3 years, 6 were male, 6 had a PM, and 4 had an ICD. Feasibility was demonstrated by successful recruitment of 10 participants, 100 % participation and completion. Anxiety decreased significantly following the intervention, with a large effect size, t[9] = 3.67, p < .01, ŋ (2) = .59. Anxiety frequency decreased from baseline to post-intervention (Fisher's exact test p = .024), and 90 % of participants reported decreased anxiety scores post-intervention. Coping skills related negatively to anxiety (r = -.65, p = .04) and depression (r = -.88, p = .001). Post-intervention, the group independently formed their own Facebook group and requested to continue meeting monthly. Although generalizability is limited due to the small sample size, this successful pilot study paves the way for larger studies to examine the efficacy of MBSR interventions in adolescents with high-risk cardiac diagnoses.
authors.affiliation: Division of Cardiology, Children's National Health System, 111 Michigan Ave., N.W., Washington, DC, 20010, USA, vfreeden@cnmc.org.
authors.forename: Vicki A
authors.initials: VA
authors.lastname: Freedenberg
authors.forename: Sue A
authors.initials: SA
authors.lastname: Thomas
authors.forename: Erika
authors.initials: E
authors.lastname: Friedmann
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D001007:Anxiety / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D017147:Defibrillators, Implantable / Q000523:psychology*; D003863:Depression / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D064866:Mindfulness / Q000379:methods*; D010138:Pacemaker, Artificial / Q000523:psychology*; D010865:Pilot Projects; D011788:Quality of Life / Q000523:psychology; D013315:Stress, Psychological / Q000628:therapy*; D016896:Treatment Outcome