Intervenções baseadas em mindfulness e dor relacionada ao câncer de mama: uma revisão de escopo

Abstract

Introduction: breast cancer, as well as the consequences of its treatment, can cause symptoms such as chronic pain, which can negatively impact the lives of the affected women. The complexity of this condition requires management with a multimodal approach, considering the multiplicity of factors that can modulate the perception of pain. Objective: To map the available evidence on the use of mindfulness-based interventions for pain management in people diagnosed with breast cancer, at different stages of the disease and stages of the treatment. Methods: This is a scope review, following the guidelines of the Joanna Briggs Institute; Therefore, 3 stages of research were followed, the first of which involved the elaboration of a search strategy and its refinement, the second, the search in all databases and the third the search in the references of the publications found in the previous phase, in addition to the search in the gray literature. The eligibility criteria were developed using the PCC mnemonic (population, concept and context), including research publications carried out with women aged 18 years or above, who were diagnosed with breast cancer (population), who experienced interventions based on mindfulness directed to pain management (concept), in any clinical context (context). Publications of quantitative and qualitative studies, systematic reviews and meta-analyses, economic evidence studies, in addition to the so-called gray literature were included. No language and time limitations were placed. The databases used were PubMed, CINAHL, Web of Science, BVS, PsycInfo and Google Scholar. The protocol of this review was registered at Open Science Framework. Results: Were presented graphically and through a narrative summary, written according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses - Scoping Review (PRISMA-ScR). A total of 58 publications were included for analysis, 36 of which were primary studies, 18 literature reviews and 4 clinical guidelines. There was great heterogeneity in the results of mindfulness-based interventions for pain management, whereas in some of them the effects obtained from mindfulness-based interventions for pain were not significant in terms of pain intensity, however, they presented good results on variables that may indicate that the mindfulness-based intervention enabled better management of the painful symptom and improve of the negative impact of pain on women’s lives. Pain has been evaluated, on those studies, mainly by instruments validated for this purpose. Conclusion: Mindfulness-based interventions have been used for pain management on women with breast cancer, on different stages of the disease and/or treatment, whether face-to-face, online or through apps. Several studies included in this review presented significant results for pain management in the studied population, although part of the studies did not present significant results. Some results involved the interaction of other variables with pain, such as moderators of the obtained effect or mediators.