A REVIEW ON THE EFFECTS OF MINDFULNESS-BASED INTERVENTIONS ON ANXIETY AND DEPRESSION IN PATIENTS WITH CHRONIC ILLNESSES: A CASE STUDY OF GENERAL HOSPITAL, BWARI

CHAPTER ONE

INTRODUCTION

1.1 Background to the Study

Chronic illnesses such as diabetes, cancer, cardiovascular disease, and respiratory disorders are not only physically debilitating but also significantly affect the mental health of patients. Anxiety and depression are common psychological challenges associated with chronic illnesses, often exacerbating the physical symptoms and making overall disease management difficult. According to Goesling (2023) chronic illnesses not only lead to long-term physical disability but are also associated with significant psychological distress, primarily anxiety and depression. This combination of mental and physical health challenges exacerbates the patient’s overall health condition, often leading to poor treatment adherence and worsened quality of life. For many patients, traditional methods of treating anxiety and depression, such as pharmacological interventions, may prove inadequate or lead to undesirable side effects. Hence, alternative interventions, such as mindfulness-based therapies, have gained traction in recent years. 

Mindfulness-based interventions (MBIs) focus on helping individuals become more aware of their thoughts and feelings, encouraging present-moment awareness without judgment (Kabat-Zinn, 2023). Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) have been shown to alleviate symptoms of anxiety and depression, particularly in people managing chronic illnesses. Studies suggest that mindfulness practices can help patients reduce negative thought patterns, manage stress, and improve emotional well-being. Goyal et al., (2024) highlighted that these interventions promote mental resilience by helping patients deal with the psychological burden of chronic illness. Therefore, the role of MBIs in improving the mental health of patients with chronic diseases has become a focal point in both clinical and psychological research.

Contextually, in many tertiary  hospitals across Nigeria, managing chronic illness involves a multidimensional approach. While medical care primarily focuses on addressing physical symptoms, psychological factors such as anxiety and depression are often overlooked. Consequently, there is a pressing need to integrate psychological interventions into the healthcare management of chronic disease patients in the hospital. In response, mindfulness-based interventions have been proposed as a means to mitigate the emotional burden on these patients, thereby enhancing overall well-being. Recent research in clinical settings globally has indicated that mindfulness practices can reduce the symptoms of anxiety and depression in people with chronic conditions. A meta-analysis by Bohlmeijer & Sanusi (2020) found that MBIs produced a moderate reduction in symptoms of depression and anxiety among chronic illness patients. Similarly, Piet, Uzziah & Fredrick (2022) concluded that mindfulness interventions lead to sustained improvements in mental health outcomes for patients dealing with chronic health issues. Given the significant psychological strain associated with chronic illnesses, the introduction of mindfulness-based approaches in healthcare settings, such as the General Hospital, could serve as a viable option for enhancing patient care. This review aims to evaluate the effects of mindfulness-based interventions on anxiety and depression in patients with chronic illnesses at General Hospital, Bwari.

1.2 Statement of the Problem

In recent times, the psychological effects of chronic illnesses are particularly troubling in Nigerian hospitals, where the focus of healthcare is predominantly on the physical aspects of the disease, leaving mental health largely unattended. In public hospitals, the current treatment models for chronic illness do not sufficiently address the mental health challenges that accompany long-term diseases, resulting in suboptimal patient outcomes. Research conducted by McCracken et al. (2022) highlighted the importance of addressing both physical and psychological symptoms of chronic illnesses to achieve holistic patient care. 

Studies by Zeidan & Zane (2024) show that mindfulness-based interventions can significantly reduce these psychological symptoms, but this approach has not been widely adopted in public hospital, despite the increasing global recognition of its efficacy. Moreover, studies in different settings have found that MBIs enhance both mental and physical health in patients with chronic diseases (Grossman et al., 2010). However, there remains limited evidence regarding the application and effectiveness of such interventions within Nigerian healthcare contexts.

 Bizarrely, in General Hospital, Bwari, this gap in healthcare delivery leaves patients with chronic conditions susceptible to the negative impacts of untreated anxiety and depression. The lack of empirical evidence on the application of mindfulness-based interventions in Nigerian hospitals has limited the ability of healthcare providers to incorporate these strategies into routine care for chronic illness patients. This gap is particularly make patients with chronic illnesses unable to benefit from comprehensive mental health support systems. Therefore, this research seeks to fill this gap by critically reviewing the effects of mindfulness-based interventions on anxiety and depression in patients with chronic illnesses at General Hospital, Bwari, contributing to the discourse on holistic healthcare delivery.

1.3 Objectives of the Study

The objective of this study is focused on the effects of mindfulness-based interventions on anxiety and depression in patients with chronic illnesses: a case study of General Hospital, Bwari. Specifically, the study seeks to:

evaluate the prevalence of anxiety and depression among chronic illness patients at General Hospital, Bwari.

To assess the impact of mindfulness-based interventions on anxiety symptoms in patients with chronic illnesses.

To determine the effectiveness of mindfulness-based interventions in reducing depression symptoms in patients with chronic illnesses.

To explore the feasibility of integrating mindfulness-based interventions into routine healthcare management for chronic illness patients in General Hospital, Bwari.

1.4 Research Questions

What is the prevalence of anxiety and depression among chronic illness patients at General Hospital, Bwari?

How effective are mindfulness-based interventions in reducing anxiety symptoms in chronic illness patients?

How effective are mindfulness-based interventions in alleviating depression symptoms in chronic illness patients?

Can mindfulness-based interventions be feasibly integrated into routine healthcare management at General Hospital, Bwari?

1.5 Research Hypotheses

H1: Mindfulness-based interventions do not significantly reduce anxiety and depression symptoms in patients with chronic illnesses.

Hi: Mindfulness-based interventions significantly reduce anxiety and depression symptoms in patients with chronic illnesses.

1.6 Significance of the Study

Practically, findings of this study will offer practical insights to healthcare providers at General Hospital, Bwari, on how mindfulness-based interventions can be effectively incorporated into treatment regimens for patients with chronic illnesses. This research will provide data on the mental health needs of chronic illness patients, encouraging healthcare administrators and policymakers to allocate resources towards holistic care approaches. Additionally, the results may encourage other healthcare institutions in Nigeria to adopt similar interventions, thereby improving the overall healthcare experience for patients suffering from chronic conditions.

Theoretically, this study will contribute to the existing body of knowledge on the intersection of mental and physical health in chronic illness management, particularly in the context of developing countries. It will also add to the theoretical framework regarding the effectiveness of mindfulness-based interventions in non-Western healthcare settings. By providing empirical data from General Hospital, Bwari, this research will expand the discourse on how mindfulness-based practices can alleviate anxiety and depression in chronic illness patients.

1.7 Scope of the Study

This study focuses on patients with chronic illnesses at General Hospital, Bwari, Abuja. It will evaluate the effects of mindfulness-based interventions on anxiety and depression symptoms. The study’s content will be restricted to assessing the psychological impact of MBIs, excluding the physical effects of these interventions. Geographically, the study will be limited to the Bwari area of Abuja, with a focus on a single healthcare institution.

1.8 Limitations of the Study

Like every academic endeavors, one limitation of this study is the relatively small sample size, which may affect the generalizability of the findings to other hospitals in Nigeria. Another limitation is the potential bias that may arise from self-reported data on anxiety and depression, as patients may underreport or over report symptoms based on personal perceptions. Additionally, cultural factors and stigma associated with mental health conditions in Nigeria may influence the responses of the participants.

Furthermore, the study's reliance on mindfulness-based interventions may overlook other psychological interventions that could be equally effective in managing anxiety and depression in chronic illness patients. These factors must be considered when interpreting the study’s results.

1.9 Definition of Terms

Mindfulness-Based Interventions (MBIs): A group of psychological therapies, including mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT), aimed at enhancing awareness of the present moment and reducing stress, anxiety, and depression

Chronic Illnesses: Long-term health conditions that require ongoing management and care, such as diabetes, cancer, and cardiovascular diseases

Anxiety and Depression: Mental health conditions often characterized by feelings of worry, fear, sadness, and hopelessness, which can significantly impact a person's quality of life.

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