Recently, there has been increased interest in using mindfulness-based interventions (MBIs) in brain injury rehabilitation. However, no previous qualitative research has explored the experiences of individuals with acquired brain injury (ABI) receiving these interventions. The present study, therefore, aimed to explore how individuals with ABI make sense of their experiences of learning mindfulness skills. Six focus group interviews were conducted with 14 participants with ABI after they had completed an eight-week mindfulness group. The group interviews were transcribed verbatim and analysed using Interpretative Phenomenological Analysis (IPA). Four themes provided in-depth information about participants' lived experiences of mindfulness training and being in the group; "Developmental learning process", "Group as a supportive environment for learning", "Increased awareness" and "Benefits of mindfulness". The accounts capture participants' journeys through the process of learning mindfulness skills and implementing them in their everyday lives. The findings also suggested that most participants considered mindfulness beneficial in terms of helping them to cope with the emotional and cognitive consequences of ABI.
Objectives
Targeted corticosteroid injections (CSI) are one of the treatments that can provide pain relief and thereby, enhance quality of life in patients with chronic pain. Corticosteroids (CS) are known to impair immune response. The objective was to evaluate the risk of developing post-procedural infection within 4 weeks of receiving depot CSI for chronic pain as part of on going quality improvement project. We hypothesised that interventional treatment with depot steroids will not cause a significant increase in clinical infection in the first 4 weeks.
Methods
Telephone follow-up was performed as a part of prospective longitudinal audit in a cohort of patients who received interventional treatment for chronic pain at a multidisciplinary pain medicine centre based at a university teaching hospital. Patients who received interventional treatment in the management of chronic pain under a single physician between October 2019 and December 2020 were followed up over telephone as part of on going longitudinal audits. Data was collected on any infection within 4 and 12 weeks of receiving the intervention. Outcomes collected included type of intervention, dose of depot steroids and pain relief obtained at 12 weeks following intervention.
Results
Over a 15 month period, 261 patients received pain interventions with depot CS. There was no loss to follow-up. Nine patients reported an infection within 4 weeks of receiving depot steroids (9/261, 3.4%). None of the patients tested positive for Covid-19. Eight patients (8/261, 3%) reported an infection between 5 and 12 weeks following the corticosteroid intervention. Although none of the patients tested positive for Covid-19, two patients presented with clinical and radiological features suggestive of Covid-19. Durable analgesia was reported by 51% (133/261) and clinically significant analgesia by 30% (78/261) at 12 weeks following the intervention. Failure rate was 19% (50/261).
Conclusions
Pain medicine interventions with depot steroids do not appear to overtly increase the risk for Covid-19 infection in the midst of a pandemic.
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