The effect of mindfulness-based stress reduction training before mastectomy on early postoperative pain

This single-blind randomized controlled study was designed and conducted to examine the effect of mindfulness-based stress reduction training given before mastectomy on early postoperative pain and fear of movement. The data for the study were collected between January 2022 and January 2023 in the Department of General Surgery at Cerrahpaşa Medical Faculty. A total of 40 female patients (experimental group n = 20, control group n = 20) participated in the study. The experimental group received eight sessions of mindfulness-based stress reduction training before surgery. Data were collected using the Mindful Attention Awareness Scale, Numeric Pain Rating Scale, Tampa Scale of Kinesiophobia, and a data collection form. The data were analyzed using the SPSS 22.0 software package (Statistical Package for Social Sciences IBM SPSS for Windows, Version 22.00; Armork, 2013). The normal distribution of quantitative data was checked using the Shapiro-Wilk test and the coefficient of variation. Differences between sociodemographic data and the distribution of Numeric Pain Rating Scale scores between the experimental and control groups were tested using the Student t-Test if the data were normally distributed, and the Mann Whitney U Test if they were not. Differences in the distribution of qualitative data between the experimental and control groups were analyzed using the Chi-Square or Fisher Exact Chi-Square Test. Differences in the distribution of Numeric Pain Rating Scale scores and Tampa Scale of Kinesiophobia scores over time between the groups were analyzed using Repeated Measures Analysis of Variance. It was found that 45% of the experimental group and 15% of the control group were working (p<0.05), and the post-test scores on the Mindful Attention Awareness Scale were significantly higher in the experimental group compared to the control group (p<0.05). The time to mobilization after surgery was longer in the experimental group (p<0.05), and pain levels at 6 and 12 hours post-surgery had decreased to mild-moderate levels, with pain scores in the experimental group being significantly lower than those in the control group (p<0.05). The differences between the groups in the post-test scores on the Tampa Scale of Kinesiophobia (42.75±9.24, 43.85±9.72) were not statistically significant (t=-0.37, p>0.05). The time to mobilization was statistically significantly longer in the experimental group, and the training was not found to be effective in reducing fear of movement. The results showed that mindfulness-based stress reduction training statistically and clinically significantly reduced pain levels at 6 and 12 hours post-mastectomy. It was found that mindfulness-based stress reduction training is an effective nursing intervention in reducing postoperative pain in women who have undergone mastectomy. It is recommended to conduct studies on the effectiveness of mindfulness-based stress reduction training in reducing fear of movement that develops immediately after drains are removed on the fourth day post-mastectomy, and on its long-term outcomes. Additionally, surgical nurses should be informed about mindfulness-based stress reduction techniques in the pre- and postoperative processes, and the integration of mindfulness-based stress reduction methods into surgical unit and institutional policies should be ensured..