WHAT IS MINDFULNESS?
In its simplest form, mindfulness is the practice of choosing to direct one’s attention to the present moment. This can mean being fully present while going on a bushwalk, or savouring a meal attentively and without hurrying, focusing on the experience of your senses rather than speculating about the future or worrying about the past.
Our purpose is to be a global facilitator of health and wellness through access, education and advancement of Traditional & Complementary Medicine (T&CM). The World Health Organization (WHO) advises that lifestyle-related diseases (ornon-communicable diseases) are responsible for more than 70% of deaths worldwide each year. Knowledge represents empowerment. By sharing this evidence-based, peer-reviewed research, we aim to support everyday people to take ownership of their wellness, by making informed decisions and choices in conjunction with their health professional.
How This Study Could Help Support Your Lung Health
The WHO estimates that on average, a person dies as a result of chronic obstructive pulmonary disease (COPD) every 10 seconds. This study examines the effect of mindfulness-based cognitive therapy on the psychological distress of people with COPD. It is titled:
MINDFULNESS-BASED COGNITIVE THERAPY IN COPD: A CLUSTER RANDOMISED CONTROLLED TRIAL
You can read the full study here: https://erj.ersjournals.com/content/51/2/1702082.long#sec-18
Why Is This Study Important?
A common symptom of COPD is a narrowing of airways in the lungs, which makes it difficult to breathe. This is a symptom that has been associated with psychological distress in COPD patients, given the breathlessness can worsen over the years. The Lung Foundation reports that anxiety and depression are fairly common in people with COPD, with 25% reporting symptoms of depression and 40% reporting symptoms of anxiety. Those living with COPD are also 10 times more likely to experience panic disorders or panic attacks compared with the general population.
Pulmonary rehabilitation (PR) is an established therapeutic approach for COPD. It includes providing people with disease education, physical exercise and other lifestyle interventions, and is known to be a reliable way to reduce the symptoms of COPD. However, with the global burden of COPD estimated at 251 million in 2016 and psychological distress associated with poor physical health status, finding ways to increase the effectiveness of available treatment is desirable.
In this study, researchers at a university in Denmark considered the efficacy of mindfulnessbased cognitive therapy as an addition to a standard PR program. The intervention was delivered by a clinical psychologist over 8 weeks with participants attending a 105-minute group session incorporating meditation and educational cognitive exercises, in addition to the PR program.
What Does This Mean For My Wellness?
For people living with COPD, adding mindfulness based cognitive therapy to a standard program of PR could be an effective way to reduce psychological distress, particularly if a person is experiencing depression. This randomised controlled trial reported that the reduction in psychological distress scores were maintained at the 6-month follow-up mark.
Mindfulness-based cognitive therapy may also be particularly effective for younger COPD patients, as younger participants recorded greater improvements in their anxiety and depression scores. Researchers hypothesised that this could be due to younger participants being more adept at learning the cognitive skills and tools taught in the program. However, the mean age of participants in this study was 67 years old, with the youngest participant being just under 60 years old. This means that mindfulness-based cognitive therapy has the potential to be useful for people in a large age range.
The study also measured the impact of mindfulness-based cognitive therapy on participants’ activity levels, and did not find any statistically significant effect. A possible explanation for this was that an 8-week intervention was not sufficient to initiate behaviour change regarding physical activity. Researchers therefore suggested an intervention with longer follow-up periods, and with a greater sample size.
How Does This Relate To Mindfulness?
Mindfulness involves focusing one’s attention on their current situation. Mindfulness-based cognitive therapy combines mindfulness with elements of cognitive behavioural therapy, which trains the person to relate to apply a nonjudgmental and compassionate lens to their emotions or sensations.
This study was interested in investigating the effects of mindfulness-based cognitive therapy on people with COPD, given that mindfulness has been found to be a useful complementary therapy for other chronic diseases such as cancer and cardiovascular disease.
Mindfulness is complementary therapy with customisable elements, and this characteristic was useful for this study. Mindfulness practices often involve drawing attention to the breath, which researchers considered could be problematic for COPD patients struggling with breathlessness. Given this, they tailored this aspect so that instead of focusing on the breath as a means
of meditational stabilisation, participants were asked to focus on their heartbeat, their blood flowing through their veins and the sensation of their feet on the ground – with positive results.
Key Findings About Mindfulness For Chronic Lung Disease
- Mindfulness-based cognitive therapy is likely to be an effective addition to a standard PR program, as it was linked with a “statistically significant and durable effect” on psychological distress.
- Researchers suggested that mindfulness based cognitive therapy may slow the increase of the inflammatory substance TNF-α over time. This was as people in the intervention group showed no change in their TNF-α levels in the 8-week period, whereas a statistically significant increase was found in those who received only PR.
- The study found that changes in self compassion scores significantly preceded changes in participants’ Hospital Anxiety and Depression Scale scores. Researchers hypothesised that this could be due to a COPD patient’s mental wellness being impacted by feelings of smoking-related self-blame or stigma, which was then positively modified by non-judgemental attitudes toward themselves.
Mindfulness | SoulAdvisor
Cardiovascular diseases: Chronic obstructive pulmonary disease | World Health Organization
Mindfulness-based cognitive therapy in COPD: a cluster randomised controlled trial | European Respiratory Journal
Anxiety and depression in people with lung disease | Lung Foundation Australia
Chronic obstructive pulmonary disease (COPD) | World Health Organization
Quoted from journal description
The European Respiratory Journal is a monthly peer-reviewed medical journal covering respirology. The ERJ publishes clinical and experimental work relating to all aspects of adult and paediatric respiratory medicine, including cell biology, epidemiology, immunology, oncology, pathophysiology, imaging, occupational medicine, intensive care, sleep medicine and thoracic surgery.