Efficacy of internet-delivered mindfulness for improving depression in caregivers of people with spinal cord injuries and chronic neuropathic pain; A randomized controlled feasibility trial

Hearn, Jasmine Heath and Cotter, Imogen and Finlay, Katherine A. (2018) Efficacy of internet-delivered mindfulness for improving depression in caregivers of people with spinal cord injuries and chronic neuropathic pain; A randomized controlled feasibility trial. Archives of Physical Medicine and Rehabilitation. ISSN 0003-9993

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Abstract

Objectives: To explore the feasibility and efficacy of web-based mindfulness training for carers of people with spinal cord injury (SCI). Design: Randomized controlled feasibility study with three-month follow-up. Setting: Community setting. Participants: Spouses/family caregivers of people with SCI and chronic neuropathic pain were recruited via the direct care team and advertisements. Participants were aged over 18 years (no upper age limit), with internet access for the duration of the study. Participants were randomly allocated to an eight-week online mindfulness training intervention (N=28), or to receive eight weeks of psychoeducational materials on SCI and chronic pain (N=27). Interventions: An established web-based, mindfulness training course was delivered over eight weeks. Participants completed ten minute mindfulness practices, twice per day, six days per week, totaling 960 minutes. The control group received a weekly email with psychoeducational materials (based on the established elements) on SCI and pain, for eight weeks. Main Outcome Measure: Depression severity. Results: Mindfulness reduced depression severity more than psychoeducation at T2 (mean difference = -.891, 95% CI [-1.48, -.30]) and T3 (mean difference = -1.96, 95% CI [-2.94, -.97]). Mindfulness training also reduced anxiety at T2 (mean difference = -.888, 95% CI [-1.40, -.38]) and T3 (mean difference = -2.44, 95% CI [-3.20, -1.69]). Conclusions: Results indicate that internet-delivered mindfulness training offers unique benefits, and is viable for caregivers of people with SCI and chronic neuropathic pain. Further work should explore the feasibility of combined education and mindfulness training incorporating both patient and caregiver, for optimum benefit.

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