- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05838443
Mindfulness Surgical Pain Outcomes (MNF)
March 12, 2024 updated by: Children's Hospital Medical Center, Cincinnati
Pragmatic Randomized Controlled Trial Evaluating Efficacy of Presurgical Provider-directed Behavioral and Self-directed Mindfulness Interventions in Pediatric Patients Undergoing Major Elective Surgical Procedures on Postoperative Pain Outcomes
This will be a prospective randomized study to evaluate novel, clinically feasible, easily deliverable, pragmatic ways of preemptively modifying known CPSP and behavioral risk factors for acute to chronic pain transitions in adolescents before surgery.
In addition, it will provide mechanistic insights and build a strong foundation for future large scale interventional studies that can impact outcomes positively in children undergoing surgery.
Study Overview
Status
Active, not recruiting
Conditions
Study Type
Interventional
Enrollment (Estimated)
90
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
Ohio
-
Cincinnati, Ohio, United States, 45229
- Cincinnati Children's Hospital Medical Center (CCHMC)
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- Aged 10-18 years
- English speaking
- Ability to provide assent/consent/parent permission
- Scheduled to undergo elective major musculoskeletal surgeries including spine fusion (idiopathic scoliosis only), abdominal surgeries, thoracic surgery including pectus repair, and major orthopedic joint surgeries.
Exclusion Criteria:
- Previous exposure to psychological interventions
- Surgery within 1 year
- Developmental delay
- Chronic opioid use within 6 months prior to surgery
- Severe systemic disease
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Self-directed mindfulness
|
Neurofeedback-assisted, technology-supported mindfulness via EEG-supported device delivered individually without the need for a facilitator or travel to training site.
The device allows noninvasive neural activity recording from frontal and posterior brain regions.
A dedicated smartphone application uses the EEG data to provide real-time adaptive feedback-modulating natural sounds to prompt user awareness of mind-wandering and intentional return to present experience.
A smartphone app will guide patients through attention and focus on breath exercises.
Patients will hear their distracted mind as the wind.
Wind becomes stronger if their mind wanders, prompting patient's awareness of their wandering mind and guiding the patient back to focusing on their breath without judgment of how they are doing.
Patients will be asked to practice mindfulness using the device for 20 minutes per day for 4 sessions prior to surgery.
|
Active Comparator: Provider-directed mindfulness
|
Patients will receive mental health support by a licensed social work provider who is trained in mindfulness through four 20-minute telehealth sessions.
Patients will be taught cognitive behavioral therapy (CBT) techniques to reduce pain catastrophizing and increase coping efficacy, the clinician will review patient's current sleep routine and teach concepts and strategies to improve sleep.
Patients will be guided through mindfulness and meditation exercises to improve pain and mood coping.
Mindfulness-based instructions takes patients through quieting their mind by focusing on breath, expanding focus (i.e., "at the tip of their nose" "full flow of the breath"), with emphasis on acknowledgement of arising thoughts/emotions without judgement or emotional reaction, and return attention back to breath sensation.
Principles of CBT and mindfulness will be reiterated at subsequent sessions.
|
Other: Conventional care
Control Comparator
|
Control group, as defined by our institution's standard preoperative care for given procedure, which does not include psychological preparation.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Functional Disability Index (FDI)
Time Frame: Baseline pre-intervention, post-operatively at 1 week, 2 weeks and 4 months.
|
15-item survey that assesses the extent to which children experience difficulties in completing specific tasks (for example, walking to the bathroom, eating regular meals, and being at school all day).
|
Baseline pre-intervention, post-operatively at 1 week, 2 weeks and 4 months.
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Child and Adolescent Mindfulness Measure (CAMM)
Time Frame: Baseline pre-intervention, post-operatively at 1 week, 2 weeks and 3-4 months.
|
10-item to assess 3 out of 4 facets of mindfulness: observing, acting with awareness and accepting without judgement.
Scale is 0-40 with reverse scoring 0-4, 0 being never true, 4 being always true.
Higher scores correspond to higher levels of mindfulness.
|
Baseline pre-intervention, post-operatively at 1 week, 2 weeks and 3-4 months.
|
Child Anxiety Sensitivity Index (CASI)
Time Frame: Baseline pre-intervention, post-operatively at 1 week, 2 weeks and 3-4 months.
|
18-item self-report tool designed to measure symptoms of anxiety in children and adolescents, with total scores ranging from 18-54.
The CASI has demonstrated high internal consistency in both clinical and nonclinical samples (aged 8-15.8 years), good test-retest reliability and good construct validity.
|
Baseline pre-intervention, post-operatively at 1 week, 2 weeks and 3-4 months.
|
Perioperative Opioid use
Time Frame: Postoperative inpatient (if applicable), 1 week, 2 weeks and 3-4 months postoperatively.
|
Opioid use over 4 months (total morphine equivalent dose standardized by weight).
Post-operative opioid use will be obtained from electronic medical record if patient was admitted, as well as by patient/family report.
|
Postoperative inpatient (if applicable), 1 week, 2 weeks and 3-4 months postoperatively.
|
PROMIS pain interference-short form
Time Frame: Baseline pre-intervention, post-operatively at 1 week, 2 weeks and 3-4 months.
|
8 items assessing how pain interferes with daily activities such as ambulating and doing school work.
Total score range 8-40.
|
Baseline pre-intervention, post-operatively at 1 week, 2 weeks and 3-4 months.
|
Electronic Pain Diary and PainDETECT
Time Frame: Baseline pre-intervention, post-operatively at 1 week, 2 weeks and 3-4 months.
|
Numerical rating pain scores of average pain intensity based on electronic pain ratings for one week, activity and sleep, using free phone application ("Manage my Pain" for Android and "Pain Diary" for iPhone users).
PainDETECT assesses pain nature, with high sensitivity, specificity and positive predictive accuracy in pain conditions.
|
Baseline pre-intervention, post-operatively at 1 week, 2 weeks and 3-4 months.
|
Pain Coping Efficacy
Time Frame: Baseline pre-intervention, post-operatively at 1 week, 2 weeks and 3-4 months
|
Evaluate pain coping as a mediator of association of the intervention with long-term functional and pain outcomes utilizing a 3-item subsurvey from a 39-item self-report questionnaire (PHQ pain coping questionnaire) to assess pain coping strategies and pain coping efficacy in children.
|
Baseline pre-intervention, post-operatively at 1 week, 2 weeks and 3-4 months
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Collaborators
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
January 1, 2022
Primary Completion (Estimated)
March 31, 2024
Study Completion (Estimated)
March 31, 2024
Study Registration Dates
First Submitted
April 19, 2023
First Submitted That Met QC Criteria
April 19, 2023
First Posted (Actual)
May 1, 2023
Study Record Updates
Last Update Posted (Actual)
March 15, 2024
Last Update Submitted That Met QC Criteria
March 12, 2024
Last Verified
January 1, 2024
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2022-0008
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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