Designing a Perioperative Mind-Body Intervention for Peripheral Vascular Interventions.

Autor:	Png CYM; Division of Vascular Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA., Mehta DH; Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, MA, USA.; Osher Center for Integrative Health, Brigham and Women's Hospital, Boston, MA, USA., Dua A; Division of Vascular Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA., Stephen AE; Division of Endocrine Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA., Bruce AM; Department of Surgery, Massachusetts General Hospital, Boston, MA, USA., Forsythe A; Department of Surgery, Massachusetts General Hospital, Boston, MA, USA., Chitilian HV; Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA., Bringle EJ; Department of Surgery, Massachusetts General Hospital, Boston, MA, USA., Simpson JC; Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA., Parady KM; Department of Surgery, Massachusetts General Hospital, Boston, MA, USA., McNeil LA; Department of Surgery, Massachusetts General Hospital, Boston, MA, USA., Baim MA; Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, MA, USA., Eagleton MJ; Division of Vascular Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA., Chang DC; Codman Center for Clinical Effectiveness in Surgery, Massachusetts General Hospital, Boston, MA, USA., Yeh GY; Osher Center for Integrative Health, Brigham and Women's Hospital, Boston, MA, USA.; Division of General Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Jazyk:	angličtina
Zdroj:	Global advances in integrative medicine and health [Glob Adv Integr Med Health] 2024 Sep 16; Vol. 13, pp. 27536130241285129. Date of Electronic Publication: 2024 Sep 16 (Print Publication: 2024).
DOI:	10.1177/27536130241285129
Abstrakt:	Background: Peripheral vascular interventions (PVIs) performed under procedural sedation and analgesia (PSA) can be associated with anxiety and poor compliance with patient instructions during surgery. Mind-body interventions (MBIs) such as meditation have demonstrated the potential to decrease perioperative anxiety, though this area is understudied, and no tailored interventions have been developed for the vascular surgical patient population. Objectives: We aimed to design a perioperative MBI that specifically targeted vascular surgical patients undergoing PVIs under PSA. We sought to perform this in a scientifically rigorous, multi-disciplinary collaborative manner. Methods: Following the Obesity-Related Behavioral Intervention Trials (ORBIT) model, we designed (Phase 1a) and then refined (Phase 1b) a MBI for patients undergoing PVIs under PSA to decrease perioperative anxiety and sedation and facilitate patient intraoperative compliance. Phase 1a involved a literature review, informal information gathering and synthesis, and drafting a preliminary protocol for a perioperative MBI. Phase 1b involved assembling a multi-disciplinary expert panel of perioperative and mind-body clinicians and researchers to improve the MBI using an iterative, modified Delphi approach. Results: The modified Delphi process was completed, and a consensus was reached after three iterations. The resulting MBI consisted of two seven-minute preoperative guided meditations on the day of surgery, including diaphragmatic breathing, body scans, and guided imagery emphasizing awareness of the ipsilateral leg where the vascular surgery was performed. A document delineating the integration of the MBI into the operating room workflow was produced, including details regarding the intervention's timing, duration, and modality. Conclusion: Using a multi-specialty expert panel, we designed a novel MBI in the form of a guided meditation with elements of mindfulness and guided imagery to decrease anxiety and increase intraoperative compliance for patients undergoing PVIs under PSA. A prospective pilot study is being planned to test the program's feasibility. Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. (© The Author(s) 2024.)
Databáze:	MEDLINE
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