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Reducing Delirium and Improving Patient Satisfaction With a Perioperative Mindfulness Intervention

A Mixed-Methods Pilot Study

Lisann-Goldman, Lauren R., MD; Pagnini, Francesco, PsyD, PhD; Deiner, Stacie G., MD; Langer, Ellen J., PhD

doi: 10.1097/HNP.0000000000000321
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Postoperative delirium (incidence estimated up to 82%) can be ameliorated with nonpharmacologic methods. Mindfulness has not yet been incorporated into these methods, although mindfulness has been demonstrated to help patients adapt to illness and hospitalization. To reduce postoperative delirium incidence and increase patient satisfaction, this study employs a program of thought exercises based on Langerian mindfulness. Preoperatively, cardiac surgical patients listened to a mindfulness or informational audio; mindfulness subjects were also guided by the principal investigator through mindfulness exercises. Postoperatively, mindfulness subjects were visited twice daily for mindfulness exercises. For all patients, delirium screening was performed twice daily. Before discharge, affective status and satisfaction with hospital stay were assessed. No patients who completed the study screened positive for delirium. Trends include (1) lower (improved) median anxiety and depression scores postoperatively when considering both study groups together; (2) both groups rated the hospital more favorably on global satisfaction measures; (3) both groups shared generally positive comments regarding the audio files (qualitative data). Audio files and mindfulness exercises are associated with patient satisfaction among cardiothoracic surgery patients. The absence of delirium precludes determination of the effectiveness of the intervention in reducing delirium incidence.

Icahn School of Medicine at Mount Sinai, New York (Drs Lisann-Goldman and Deiner); Mount Sinai West/Mount Sinai St Luke's, New York (Dr Lisann-Goldman); Università Cattolica del Sacro Cuore, Milan, Italy (Dr Pagnini); and Harvard University, Boston, Massachusetts (Drs Pagnini and Langer).

Correspondence: Lauren R. Lisann-Goldman, MD, 10 Amsterdam Ave, Apartment 606, New York, NY 10023 (lauren.r.lisann@gmail.com).

The authors acknowledge the late Dr Jeff Silverstein for being responsible for the inception of this project and for inspiring its progress; Dr Paul Stelzer for assent to patient recruitment; Dionne Bobb, Monique Pierre, and Jacqueline Crittendon for support in logistic and administrative work; Sandra Myerson for support in HCAHPS aspects; Ken McCardle for assistance with HCAHPS data; and Evie Andreopoulos for her assistance with randomization and REDCap.

This work was supported by the Foundation for Anesthesia Education and Research (the FAER Medical Student Anesthesia Research Fellowship—Year Long Program).

The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

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