Effects of mindfulness-based stress reduction on perioperative outcomes in patients with advanced hepatocellular carcinoma undergoing transarterial chemoembolization.
Yunyun Zhao, Juanjuan Li, Xiaobei Li, Mao Zhang, Jingxia Qin
PLoS One June 29, 2026 DOI: 10.1371/journal.pone.0352434 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Retrospective study Peer reviewed |
|---|---|
| Population | Patients with advanced hepatocellular carcinoma undergoing transarterial chemoembolization |
| Interventions | Mindfulness-based stress reduction (MBSR) standard perioperative care |
| Measures | Numerical Rating Scale (NRS), Hospital Anxiety and Depression Scale (HADS), Strategies Used by People to Promote Health (SUPPH) scale |
| Topics | Anxiety Depression Meditation |
| Keywords | Humans Carcinoma, hepatocellular Liver neoplasms Treatment outcome Chemoembolization, therapeutic Perioperative care Retrospective studies Stress, psychological Middle aged Female |
| Key points | Adding mindfulness-based stress reduction to standard perioperative care was associated with lower postoperative pain scores, reduced analgesic use, lower anxiety and depression scores, better self-care efficacy, less post-embolization syndrome, and shorter hospital stay. Mindfulness was independently associated with reduced post-embolization syndrome risk (OR 0.55, 95% CI 0.31-0.96). |
Abstract
Objective: To evaluate the effects of mindfulness-based stress reduction (MBSR) combined with standard perioperative care on perioperative outcomes in patients with advanced hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE).
Methods: This retrospective study enrolled patients with advanced HCC who underwent TACE and received either standard perioperative care alone or standard care combined with an MBSR intervention. Post-embolization syndrome (PES) was assessed 72 hours after TACE. Postoperative pain was evaluated using the numerical rating scale (NRS), while anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS). Self-care efficacy was measured using the Strategies Used by People to Promote Health (SUPPH) scale. Univariate and multivariable logistic regression analyses were performed to explore factors associated with PES.
Results: Compared with standard care, the MBSR intervention was associated with significantly lower postoperative NRS pain scores at all assessed time points, reduced use and escalation of analgesic medications, and lower anxiety and depression scores (all P < 0.05). Patients in the mindfulness group also demonstrated significantly higher SUPPH scores, indicating better self-care efficacy (P < 0.001). In addition, the incidence of PES and postoperative length of hospital stay were significantly lower in the mindfulness group. Logistic regression analysis showed that the mindfulness intervention was independently associated with a reduced risk of PES (OR = 0.55, 95% CI 0.31-0.96).
Conclusion: Mindfulness-based stress reduction combined with standard perioperative care was associated with improved pain control, psychological well-being, self-care efficacy, and reduced perioperative complications in patients with advanced HCC undergoing TACE. This intervention may serve as a feasible supportive approach in perioperative clinical practice.
Comparable studies
Other observational and cohort studies on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Using Self-Report Assessment Methods to Explore Facets of Mindfulness Undergraduate students | 2006 | Observational cohort | |
| Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders Patients with generalized anxiety disorder or panic disorder with or without agoraphobia | 1992 | Observational cohort | n = 22 |
| Meditation experience is associated with increased cortical thickness Participants with extensive Insight meditation experience and matched controls | 2005 | Observational cohort | n = 20 |
| Meditation experience is associated with differences in default mode network activity and connectivity Experienced meditators and matched meditation-naive controls | 2011 | Observational cohort | |
| Long-term meditators self-induce high-amplitude gamma synchrony during mental practice Long-term Buddhist practitioners and controls | 2004 | Observational cohort |
Citations in the library
Cites 4
- Mindfulness-Based Stress Reduction vs Escitalopram for the Treatment of Adults With Anxiety Disorders: A Randomized Clinical Trial. JAMA Psychiatry January 1, 2023
- Mindfulness-Based Stress Reduction increases stimulated IL-6 production among lonely older adults: A randomized controlled trial Brain, Behavior, and Immunity May 1, 2022
- Targeting Depressive Symptoms in Younger Breast Cancer Survivors: The Pathways to Wellness Randomized Controlled Trial of Mindfulness Meditation and Survivorship Education. Journal of Clinical Oncology November 1, 2021
- Mindfulness meditation and the immune system: a systematic review of randomized controlled trials Annals of the New York Academy of Sciences January 21, 2016