Development and Implementation of a Brief Video-Based Mindful Movement Intervention Prior to Pelvic Exams to Reduce Pain Intensity and State Anxiety


August 2021


Collins, Marielle Heather

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Mindfulness interventions have demonstrated efficacy for numerous health related outcomes, and been implemented in medical settings to reduce pain and anxiety prior to exams, surgeries, or procedures. This broad investigation begins with a theoretical review exploring a proposed mechanism of mindfulness, improved attention. It presents a theory of mindful movement as a type of mindfulness potentially more efficacious for individuals who struggle with mind-wandering, such as those with depression and anxiety. Mind-wandering and rumination are barriers to mindfulness, and movement has been shown to engage finite executive resources also utilized for mind-wandering. Mindfulness interventions with movement, may promote greater engagement for individuals with attentional challenges, compared to focused attention meditation. Mindful movement may provide a more accessible form of mindfulness for brief interventions, implemented in settings with a wide range of participants. The current study tests the efficacy of a 5-minute mindful movement video prior to pelvic examination in a sample of 99 women at an outpatient gynecology clinic, with the aim of reducing anxiety and pain. Participants were randomized into Treatment (5-minute mindful movement video; n=49) and Control (educative materials about mindfulness benefits; n=50). Upon arrival, women completed a PHQ-9, and baseline measurements of anxiety and pain using a visual analogue scale. They then completed the group specific activity and rated anxiety prior to examination. After examination participants rated exam pain, post-exam anxiety, and completed questionnaires assessing exam satisfaction and intervention acceptability. Physicians (n=2) rated ease of performing pelvic examination and ability to obtain clinical information. Results demonstrated clinically anxious individuals who completed the intervention reported significantly lower anxiety before pelvic examination (p=.000, partial η2=.262) and after (p= .010, partial η2=.126) compared to control group. No significant differences in pain, patient exam satisfaction, or physician perception of the exam were noted between groups. Acceptability and interest in the intervention was also high. This study demonstrates the ability to implement a brief mindful movement video into the flow of a medical clinic and reduce pelvic exam anxiety. In general, this broad investigation supports ongoing research exploring mindful movement from a mechanistic perspective, and the implementation of brief mindful movement interventions in medical settings.

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