The Effects of a Mindfulness-based Nursing Rehabilitation Program on Physical Functioning, Psychological Distress and Spiritual Well-being of Thai Buddhist Patients with Lower Extremity Injury

Abstract

The purpose of this study was to evaluate the effects of a mindfulness- based nursing rehabilitation program (MNRP) on physical functioning, psychological distress, and spiritual well-being of Thai Buddhist with lower extremity injury. The program was developed based on Buddhist philosophy and Roy's Adaptation Model by integration of Luangpor Teean's awareness-mindfulness meditation and a home- based rehabilitation. Thirty-four eligible participants admitted in a tertiary care hospital were randomly assigned to either the experimental group (n=17) or the control group (n=17). The experimental group received MNRP while the control group received routine care. Three main outcomes were evaluated at 1 month and 3 months after injury and included 1) physical functioning assessed by muscle strength (MS) and passive range of motion (PROM) of hip and knee joint, 2) psychological distress by brief symptom inventory-18 (BSI-18) and 3) spiritual well-being by spirituality index well-being (SIWB). Data were analyzed using Profile analysis, repeated measures Friedman test, Wilcoxon signed-rank test, and Mann Whitney U test to evaluate the effects of the MNRP. The results showed that the experimental group had significantly higher physical functioning and spiritual well-being; and lower psychological distress across time at 1 and 3 months from baseline. Moreover, the experimental group had higher physical functioning (both muscle strength and PROM of knee flexion), higher spiritual well-being; and lower psychological distress at all-time points compared to the control group. The MNRP is easy to follow and appropriate for patients to practice. It is suggested that the MNRP can be one strategy to apply by integrating it into the routine care for orthopedic patients in order to improve physical functioning and spiritual well-being and reduce psychological distress. However, a larger sample size and more diverse group of participants is recommended in future research.