Effects of a Mindfulness-based Intervention on Chronic Pain Sufferers: Lessons Learned from a Replicated Single-case Design Study in an Indian Setting

Abstract

Introduction: Chronic pain is an emerging healthcare problem in India. Chronic pain is not physical pain alone it has psychological, social, and economic perspectives. The treatment modalities of chronic pain in India mostly focus on physical pain. It is important to search for an optimal-cost selfhelp therapy that can help the sufferer to live a meaningful life despite the chronic pain. Mindfulness, gaining popularity in the western world maybe a viable option. Aim: To explore the preliminary effects of mindfulness on different outcome variables like pain intensity, chronic pain acceptance, anxiety and depression and World Health Organisation-Quality Of Life (WHO-QOL) in Indian chronic pain sufferers. Materials and Methods: This replicated single-case design study was conducted at Harmony Mindfulness Centre and Kalyani ESI Hospital, Kolkata, West Bengal, India from December 2020 to May 2021. The effects of a face-to-face eight-week mindfulness based intervention were studied in six chronic pain sufferers. The quantitative variables like Numerical Rating scale (NRS), Chronic Pain Acceptance Questionnaire (CPAQ), WHO-QOL, and Hospital Anxiety and Depression Score (HADS) were studied at three time points; pre-session, immediate post-session and six months after completion of the session. Reliable Change (RC) based on Reliable Change Index (RCI) was calculated and modulus RC i.e., |RC| > 1.96 was considered to be statistically significant with p-value <0.05. Qualitative data was collected post-session by getting written responses to a question “How did you experience the effects of this mindfulness based intervention?” The responses were categorised into five emergent themes to determine which aspect of the programme appealed to the participants the most. Results: The pre-session variables showed significant improvement (p-value <0.05) based on the reliability change index in post-session. The post-session improvement in the variables was maintained even at six months follow-up. Positive mental state was the most common theme marked by participant’s post-session. Conclusion: The Mindfulness-Based Intervention (MBI) has a positive impact on pain intensity, chronic pain acceptance, anxiety and depression and QOL of Indian chronic pain sufferers.

Keywords

• chronic pain acceptance
• positive mental state
• self-help therapy