Effectiveness of an online mindfulness based stress reduction intervention on psychological distress among patients with COVID19 after hospital discharge

Given the high prevalence of psychological complications during pandemics such as COVID-19, it is imperative to identify effective psychological interventions that can improve the mental health of patients and community members. The effectiveness of mindfulness-based intervention in discharged patients with infectious respiratory diseases, particularly during pandemics, has been examined in a limited number of studies. This study aimed to investigate the effectiveness of an online Mindfulness-Based Stress Reduction (MBSR) training program in alleviating psychological distress, depression, anxiety, and stress among patients who have passed the acute phase of COVID-19 and have been discharged from the hospital. This was a quasi-experimental study included 70 hospitalized patients with COVID-19 (29 [41.4%] men and 41 [58.6%] women) who were discharged from three teaching hospitals in Tehran, Iran, between September 11, 2021, and January 10, 2022 were selected by convenience sampling. Participants were randomly assigned to either the control or intervention group (35 per group). The intervention group received a 4-week online MBSR training program based on Jon Kabat-Zinn's recommendations (2003), while the control group followed the routine hospital discharge plan. Research data were collected using the Lovibond (1995) Depression, Anxiety, and Stress Scale (DASS). The results were compared before and after the intervention. Data analysis was conducted using SPSS version 21, employing descriptive statistics as well as paired and independent sample t-tests. Cohen's d was used to determine effect sizes. The post-test score of stress after the online MBSR training program for 4 weeks significantly decreased in the MBSR group to 12.59 ± 6.77 compared with the control group which had a score of 22.60 ± 10.82(p < 0.001). The total anxiety score significantly decreased, with scores of 8.68 ± 6.52 for the MBSR group versus 18.16 ± 13.37 for the control group (p < 0.001). The depression score in the intervention group (8.68 ± 6.52) was significantly lower compared to the depression score in the control group (18.16 ± 13.37) after the intervention (p < 0.001). This study provides preliminary evidence that online MBSR intervention can serve as an effective measure to reduce depression, stress and anxiety during pandemics such as the COVID-19 crisis. Policymakers and healthcare managers can integrate public mindfulness-based intervention training into crisis management planning to reduce psychological complications and enhance resilience during disasters such as the COVID-19 pandemic.Trial registration. The current study was approved by the Research Ethics Committee of the Faculty of Pharmacy, Nursing and Midwifery of Shahid Beheshti University of Medical Sciences on 10/08/2021 with the registration code IR.SBMU.PHARMACY.REC.1400. 108. In addition, the study protocol was registered with the Iranian Clinical Trial Registration Center on 03/06/2022 under the code IRCT20210715051896N1.