The Effects of Mindfulness Practices in the Perioperative Process in Surgical Patients

Öz

Mindfulness is a state of awareness that arises from paying attention to present experiences in a deliberate and conscious manner, without judgment. Mindfulness, which consists of the components of attention, intention, and attitude, enables individuals to focus on their ongoing experiences. Mindfulness-based practices such as yoga, listening to music, cognitive therapy, art therapy, mindful eating, and mindful walking have a wide range of applications in education, sports, professional life, daily life, and healthcare. In healthcare, the perioperative period is a critical time that causes intense stress for patients and requires alternative support methods. When incorporated into perioperative care, mindfulness-based practices have positive effects on patients' psychological and physiological parameters. These practices have been shown to reduce pain, anxiety, and the need for analgesics, while also improving quality of life and accelerating the recovery process. Additionally, the use of mindfulness interventions before and after surgery contributes to a decrease in stress hormone levels, heart rate, and blood pressure. Due to their practical applicability and low cost, mindfulness-based interventions are recommended as effective support strategies to be integrated into perioperative care. This facilitates recovery in surgical patients and leads to better outcomes.

Anahtar Kelimeler

• Anxiety
• Mindfulness
• Pain
• Perioperative care

Cerrahi Hastalarında Bilinçli Farkındalık Uygulamalarının Perioperatif Süreçteki Etkileri

Öz

Bilinçli farkındalık, mevcut anda ortaya çıkan deneyimlerini yargılamadan isteyerek ve bilerek dikkat verme yoluyla ortaya çıkan farkındalık halidir. Dikkatlilik, niyet ve tutum bileşenleri ile kişilerin o anki deneyimlerine odaklanmalarını sağlamaktadır. Bilinçli farkındalık temelli yoga, müzik dinleme, bilişsel terapi, bilinçli farkındalık temelli sanat terapisi, yeme farkındalığı, yürüyüş farkındalığı gibi yöntemleri ile eğitimde, sporda, çalışma hayatında, günlük yaşamda ve sağlık alanında geniş bir kullanıma sahiptir. Sağlık alanında özellikle perioperatif süreç, hasta için yoğun stres yaratan ve alternatif destek yöntemlerine ihtiyaç duyulan kritik bir dönemdir. Bilinçli farkındalık uygulamaları perioperatif süreçte kullanıldığında hastaların psikolojik ve fizyolojik parametreleri üzerinde olumlu etkilere sahiptir. Bu sayede hastalarda ağrı, analjezi kullanımı ve anksiyeteyi azaltmakta, yaşam kalitelerini ise artırarak iyileşme sürecini hızlandırmaktadır. Bilinçli farkındalık temelli uygulamaların ameliyat öncesinde ve sonrasında kullanımı ile stres hormonlarının, kalp atım hızının ve kan basıncının azalması sağlanabilmektedir. Pratik uygulanabilirliği ve düşük maliyeti nedeniyle bilinçli farkındalık temelli girişimlerin perioperatif bakıma entegre edilmesi, cerrahi hastalarında iyileşme sürecini destekleyecek etkili bir yöntem olarak önerilmektedir.

Anahtar Kelimeler

• Ağrı
• Anksiyete
• Farkındalık
• Perioperatif bakım

Kaynakça

1. Almuhtadi, Y., & Alageel, S. (2023). Systematic Review of Mindfulness-Based Interventions for Weight Management Among Pre- and Post-bariatric Surgery Patients. Advances in mind-body medicine, 37(3), 15–22.
2. Arenilla Villalba, M. J., Alarcón Rubio, D., & Povedano Díaz, M. A. (2022). Multilevel meta-analysis of school mindfulness-based intervention programs in Spain. Revista de Psicodidáctica (English ed.), 27(2), 109–117. https://doi.org/10.1016/j.psicoe.2022.05.002
3. Barton, M. F., Groves, J., Guevel, B., Saint, K., Barton, B. L., Hamza, M., & Papatheodorou, S. I. (2023). Mindfulness-Based Interventions for the Reduction of Postoperative Pain in Hip and Knee Arthroplasty Patients: A Systematic Review and Meta-Analysis. Cureus, 15(6), e40102. https://doi.org/10.7759/cureus.40102
4. Black, D. S., & Slavich, G. M. (2016). Mindfulness meditation and the immune system: a systematic review of randomized controlled trials. Annals of the New York Academy of Sciences, 1373(1), 13–24. https://doi.org/10.1111/nyas.12998
5. Calderone, A., Latella, D., Impellizzeri, F., de Pasquale, P., Famà, F., Quartarone, A., & Calabrò, R. S. (2024). Neurobiological Changes Induced by Mindfulness and Meditation: A Systematic Review. Biomedicines, 12(11), 2613. https://doi.org/10.3390/biomedicines12112613
6. Carsley, D., Khoury, B., & Heath, N. L. (2018). Effectiveness of mindfulness interventions for mental health in schools: A comprehensive meta-analysis. Mindfulness, 9(2), 693–707. https://doi.org/10.1007/s12671-017-0839-2
7. Chavez, J. L., Porucznik, C. A., Gren, L. H., Guan, J., Joyce, E., Brodke, D. S., Dailey, A. T., Mahan, M. A., Hood, R. S., Lawrence, B. D., Spiker, W. R., Spina, N. T., & Bisson, E. F. (2020). The Impact of Preoperative Mindfulness-Based Stress Reduction on Postoperative Outcomes in Lumbar Spine Degenerative Disease: 3-Month and 12-Month Results of a Pilot Study. World neurosurgery, 139, e230–e236. https://doi.org/10.1016/j.wneu.2020.03.186
8. Chayadi, E., Baes, N., & Kiropoulos, L. (2022). The effects of mindfulness-based interventions on symptoms of depression, anxiety, and cancer-related fatigue in oncology patients: A systematic review and meta-analysis. PloS one, 17(7), e0269519. https://doi.org/10.1371/journal.pone.0269519

9. Cohen, C., Pignata, S., Bezak, E., Tie, M., & Childs, J. (2023). Workplace interventions to improve well-being and reduce burnout for nurses, physicians and allied healthcare professionals: a systematic review. BMJ open, 13(6), e071203. https://doi.org/10.1136/bmjopen-2022-071203
10. Creswell J. D. (2017). Mindfulness Interventions. Annual review of psychology, 68, 491–516. https://doi.org/10.1146/annurev-psych-042716-051139
11. Dahl, C. J., Lutz, A., & Davidson, R. J. (2015). Reconstructing and deconstructing the self: cognitive mechanisms in meditation practice. Trends in cognitive sciences, 19(9), 515–523. https://doi.org/10.1016/j.tics.2015.07.001
12. Elices, M., Pérez-Sola, V., Pérez-Aranda, A., Colom, F., Polo, M., Martín-López, L. M., & Gárriz, M. (2022). The Effectiveness of Mindfulness-Based Cognitive Therapy in Primary Care and the Role of Depression Severity and Treatment Attendance. Mindfulness, 13(2), 362–372. https://doi.org/10.1007/s12671-021-01794-3
13. Fortes, P. P., Dos Santos-Ribeiro, S., de Salles-Andrade, J. B., Moreira-de-Oliveira, M. E., de Abreu-Cervone, F., de Faro, L. F. T., de Melo-Fadel, B. T. M., de Menezes, G. B., & Fontenelle, L. F. (2025). Mindfulness interventions and quality of life in anxiety-related disorders: A systematic review and meta-analysis. Journal of affective disorders, 373, 383–393. https://doi.org/10.1016/j.jad.2024.12.103
14. Goldin, P. R., Thurston, M., Allende, S., Moodie, C., Dixon, M. L., Heimberg, R. G., & Gross, J. J. (2021). Evaluation of Cognitive Behavioral Therapy vs Mindfulness Meditation in Brain Changes During Reappraisal and Acceptance Among Patients With Social Anxiety Disorder: A Randomized Clinical Trial. JAMA psychiatry, 78(10), 1134–1142. https://doi.org/10.1001/jamapsychiatry.2021.1862
15. Gong, X. G., Wang, L. P., Rong, G., Zhang, D. N., Zhang, A. Y., & Liu, C. (2023). Effects of online mindfulness-based interventions on the mental health of university students: A systematic review and meta-analysis. Frontiers in psychology, 14, 1073647. https://doi.org/10.3389/fpsyg.2023.1073647
16. Grutz, K., & Poch, N. (2021). Meditation for Preoperative Anxiety and Postoperative Pain in Bariatric Surgery. Journal of PeriAnesthesia Nursing, 36(6), 586–590. https://doi.org/10.1016/j.jopan.2021.04.003
17. Hanley, A. W., Gilliland, J., Erickson, J., Pelt, C., Peters, C., Rojas, J., & Garland, E. L. (2021). Brief preoperative mind-body therapies for total joint arthroplasty patients: A randomized controlled trial. Pain, 162(6), 1749–1757. https://doi.org/10.1097/j.pain.0000000000002195
18. Hymowitz, G., Hasan, F., Yerramalli, G., & Cervoni, C. (2022). Mindfulness-Based Interventions for Surgical Patients and Impact on Postoperative Outcomes, Patient Wellbeing, and Satisfaction. The American surgeon, 90(5), 947–953. https://doi.org/10.1177/00031348221117025
19. Iaccarino Idelson, P., D’Elia, L., & Strazzullo, P. (2024). Mindful Eating Approaches to Cardiometabolic Risk Factors: Systematic Review and Meta-Analysis of Intervention Studies. Dietetics, 3(3), 271-288. https://doi.org/10.3390/dietetics3030022
20. Kabat-Zinn, J. (2005). Coming to our senses: Healing ourselves and the world through mindfulness. Hyperion.
21. Kabat-Zinn, J. (2017). Yoga. Mindfulness, 8(3), 517–519. https://doi.org/10.1007/s12671-017-0695-0life. Hachette UK.
22. Kabat-Zinn, J. (2023). Wherever you go, there you are: Mindfulness meditation in everyday
23. Kang, C., & Whittingham, K. (2010). Mindfulness: A dialogue between Buddhism and clinical psychology. Mindfulness, 1(3), 161–173. https://doi.org/10.1007/s12671-010-0018-1
24. Levey, J., & Levey, M. (2018). Roots and shoots of mindfulness. Subtle Energies Magazine, 28(3)
25. Li, Z., Lei, D., Ting, L., Yao, R., Jing, W., & Na, M. (2024). The impact of mindfulness intervention on negative emotions and quality of life in malignant tumor patients: a systematic review and meta-analysis. Frontiers in psychology, 15, 1443516. https://doi.org/10.3389/fpsyg.2024.1443516
26. Lindsay, E. K., Young, S., Smyth, J. M., Brown, K. W., & Creswell, J. D. (2018). Acceptance lowers stress reactivity: Dismantling mindfulness training in a randomized controlled trial. Psychoneuroendocrinology, 87, 63–73. https://doi.org/10.1016/j.psyneuen.2017.09.015
27. Liu, X., Shi, H., Liu, Y., Yuan, H., & Zheng, M. (2021). Mindfulness Meditation Improves Musical Aesthetic Emotion Processing in Young Adults. International journal of environmental research and public health, 18(24), 13045. https://doi.org/10.3390/ijerph182413045
28. Liu, W., Liu, J., Ma, L., & Chen, J. (2022). Effect of mindfulness yoga on anxiety and depression in early breast cancer patients received adjuvant chemotherapy: a randomized clinical trial. Journal of cancer research and clinical oncology, 148(9), 2549–2560. https://doi.org/10.1007/s00432-022-04167-y
29. Liu, W., Liu, X. M., Huang, Y. L., Yu, P. M., Zhang, X. W., Zhao, C., Mao, B., Min, J., & Jiang, H. L. (2023). Tai Chi as a complementary exercise for pulmonary rehabilitation in chronic obstructive pulmonary disease: A randomised controlled trial. Complementary therapies in medicine, 78, 102977. https://doi.org/10.1016/j.ctim.2023.102977
30. Lupien, S. J., Juster, R. P., Raymond, C., & Marin, M. F. (2018). The effects of chronic stress on the human brain: From neurotoxicity, to vulnerability, to opportunity. Frontiers in Neuroendocrinology, 49, 91–105. https://doi.org/10.1016/j.yfrne.2018.02.001
31. Marchand W. R. (2014). Neural mechanisms of mindfulness and meditation: Evidence from neuroimaging studies. World journal of radiology, 6(7), 471–479. https://doi.org/10.4329/wjr.v6.i7.471
32. Mazgelytė, E., Rekienė, V., Dereškevičiūtė, E., Petrėnas, T., Songailienė, J., Utkus, A., Chomentauskas, G., & Karčiauskaitė, D. (2021). Effects of Virtual Reality-Based Relaxation Techniques on Psychological, Physiological, and Biochemical Stress Indicators. Healthcare (Basel, Switzerland), 9(12), 1729. https://doi.org/10.3390/healthcare9121729
33. Miao, C., Gao, Y., Li, X., Liu, T., Li, W., & Wang, Z. (2023). The effectiveness of mindfulness yoga on patients with major depressive disorder: A systematic review and meta-analysis of randomized controlled trials. BMC Complementary Medicine and Therapies, 23, 313. https://doi.org/10.1186/s12906-023-04141-2
34. Michaelsen, M. M., Graser, J., Onescheit, M., Tuma, M. P., Werdecker, L., Pieper, D., & Esch, T. (2023). Mindfulness-Based and Mindfulness-Informed Interventions at the Workplace: A Systematic Review and Meta-Regression Analysis of RCTs. Mindfulness, 1–34. Advance online publication. https://doi.org/10.1007/s12671-023-02130-7
35. Nandarathana, N., & Ranjan, J. K. (2024). The Efficacy and Durability of Mindfulness-Based Cognitive Therapy in the Treatment of Anxiety and Depressive Disorders: A Systematic Review and Meta-analysis. Indian journal of psychological medicine, 02537176241249375. Advance online publication. https://doi.org/10.1177/02537176241249375
36. Newland, P., & Bettencourt, B. A. (2020). Effectiveness of mindfulness-based art therapy for symptoms of anxiety, depression, and fatigue: A systematic review and meta-analysis. Complementary Therapies in Clinical Practice, 41, 101246. https://doi.org/10.1016/j.ctcp.2020.101246
37. Norweg, A. M., Wu, Y., Troxel, A., Whiteson, J. H., Collins, E., Haas, F., Skamai, A., Goldring, R., Jean-Louis, G., Reibman, J., Ehrlich-Jones, L., & Simon, N. (2023). Mind-Body Intervention for Dysfunctional Breathing in Chronic Obstructive Pulmonary Disease: Feasibility Study and Lessons Learned. Journal of integrative and complementary medicine, 29(3), 156–168. https://doi.org/10.1089/jicm.2022.0552
38. Özok, H. İ., & Tanhan, F. (2018). Kültüre duyarlı hazırlanan stres azaltma programında bilinçli farkındalık unsurları ve Türk kültüründeki karşılıkları. International Journal of Social and Humanities Sciences Research (JSHSR), 5(30), 4469–4480. https://doi.org/10.26450/jshsr.933
39. Palmer Kelly, E., McGee, J., Klatt, M., Beckers, G., & Pawlik, T. M. (2024). The Use of Brief Mindfulness Interventions in the Context of Perioperative Care. The American surgeon, 90(6), 1657–1665. https://doi.org/10.1177/00031348241230092
40. Ploesser, M., & Martin, D. (2024). Mechanism of Action of Mindfulness-Based Interventions for Pain Relief-A Systematic Review. Journal of integrative and complementary medicine, 30(12), 1162–1178. https://doi.org/10.1089/jicm.2023.0328
41. Reive, C. (2019). The biological measurements of mindfulness-based stress reduction: A systematic review. Explore, 15(4), 295–307. https://doi.org/10.1016/j.explore.2019.01.001
42. Reynolds, A., & Hamidian Jahromi, A. (2022). Improving Postoperative Care Through Mindfulness-Based and Isometric Exercise Training Interventions: Systematic Review. JMIR perioperative medicine, 5(1), e34651. https://doi.org/10.2196/34651
43. Rotter, G., Ortiz, M., Binting, S., Tomzik, J., Reese, F., Roll, S., Brinkhaus, B., & Teut, M. (2022). Mindful walking in patients with chronic low back pain: A randomized controlled trial. Journal of Integrative and Complementary Medicine, 28(6), 474–483. https://doi.org/10.1089/jicm.2021.0361
44. Ruffault, A., Czernichow, S., Hagger, M. S., Ferrand, M., Erichot, N., Carette, C., Boujut, E., & Flahault, C. (2017). The effects of mindfulness training on weight-loss and health-related behaviours in adults with overweight and obesity: A systematic review and meta-analysis. Obesity research & clinical practice, 11(5 Suppl 1), 90–111. https://doi.org/10.1016/j.orcp.2016.09.002
45. Scott-Sheldon, L. A. J., Gathright, E. C., Donahue, M. L., Balletto, B., Feulner, M. M., DeCosta, J., Cruess, D. G., Wing, R. R., Carey, M. P., & Salmoirago-Blotcher, E. (2020). Mindfulness-Based Interventions for Adults with Cardiovascular Disease: A Systematic Review and Meta-Analysis. Annals of behavioral medicine : a publication of the Society of Behavioral Medicine, 54(1), 67–73. https://doi.org/10.1093/abm/kaz020
46. Shi, H., Liu, Y., Liu, Y., Zheng, M., & Liu, X. (2024). Effects of mindfulness-based music listening on conflict control in young adults with insomnia disorder: Behavioral and event-related potential evidence. Frontiers in Psychology, 15, 1404000. https://doi.org/10.3389/fpsyg.2024.1404000
47. Si, X. W., Yang, Z. K., & Feng, X. (2024). A meta-analysis of the intervention effect of mindfulness training on athletes' performance. Frontiers in psychology, 15, 1375608. https://doi.org/10.3389/fpsyg.2024.1375608 Togo, E., Takami, M., & Ishigaki, K. (2024). Evaluation of Autonomic Nervous System Function During Sleep by Mindful Breathing Using a Tablet Device: Randomized Controlled Trial. JMIR nursing, 7, e56616. https://doi.org/10.2196/56616
48. Tomlinson, E. R., Yousaf, O., Vitterso, A. D., & Jones, L. (2018). Dispositional mindfulness and psychological health: a systematic review. Mindfulness, 9(1), 23–43. https://doi.org/10.1007/s12671-017-0762-6
49. Tung, K. M., Su, Y., Kang, Y. N., Hou, W. H., Hoang, K. D., Chen, K. H., & Chen, C. (2024). Effects of mindfulness-based preoperative intervention for patients undergoing elective surgery: A meta-analysis. Journal of psychosomatic research, 181, 111666. https://doi.org/10.1016/j.jpsychores.2024.111666
50. Türk Dil Kurumu. (2024a). [farkındalık]. https://sozluk.gov.tr/ (Erişim tarihi: 7 Temmuz 2025)
51. Türk Dil Kurumu. (2024b). [farkında olmak]. https://sozluk.gov.tr/ (Erişim tarihi: 7 Temmuz 2025)
52. Van Dyck, D., Cerin, E., De Bourdeaudhuij, I., Hinckson, E., Reis, R. S., Davey, R., Sarmiento, O. L., Mitas, J., Troelsen, J., MacFarlane, D., Salvo, D., Aguinaga-Ontoso, I., Owen, N., Cain, K. L., & Sallis, J. F. (2015). International study of objectively measured physical activity and sedentary time with body mass index and obesity: IPEN adult study. International journal of obesity (2005), 39(2), 199–207. https://doi.org/10.1038/ijo.2014.115
53. Villa, G., Lanini, I., Amass, T., Bocciero, V., Scirè Calabrisotto, C., Chelazzi, C., Romagnoli, S., De Gaudio, A. R., & Lauro Grotto, R. (2020). Effects of psychological interventions on anxiety and pain in patients undergoing major elective abdominal surgery: a systematic review. Perioperative medicine (London, England), 9(1), 38. https://doi.org/10.1186/s13741-020-00169-x
54. Vonderlin, R., Biermann, M., Bohus, M., & Lyssenko, L. (2020). Mindfulness-based programs in the workplace: A meta-analysis of randomized controlled trials. Mindfulness, 11(7), 1579–1598. https://doi.org/10.1007/s12671-020-01328-3
55. Wang, Y., Lei, S. M., & Fan, J. (2023). Effects of Mindfulness-Based Interventions on Promoting Athletic Performance and Related Factors among Athletes: A Systematic Review and Meta-Analysis of Randomized Controlled Trial. International journal of environmental research and public health, 20(3), 2038. https://doi.org/10.3390/ijerph20032038
56. Wang, X., Lu, Y., Gu, C., Shao, J., Yan, Y., & Zhang, J. (2024). Mindfulness Meditation Reduces Stress and Hospital Stay in Gastrointestinal Tumor Patients During Perioperative Period. Medical science monitor : international medical journal of experimental and clinical research, 30, e945834. https://doi.org/10.12659/MSM.945834
57. Xu, F., Zhu, W., Chen, Q., & Tang, Y. (2024). Online mindfulness interventions for improving people’s mental health during the COVID-19 pandemic: A meta-analysis of randomized controlled trials. Current Psychology: A Journal for Diverse Perspectives on Diverse Psychological Issues, 43(19), 17751–17765. https://doi.org/10.1007/s12144-023-05188-7
58. Zeidan, F. and Vago, D.R. (2016), Mindfulness meditation–based pain relief: a mechanistic account. Ann. N.Y. Acad. Sci., 1373: 114-127. https://doi.org/10.1111/nyas.13153
59. Zhang, D., Lee, E. K. P., Mak, E. C. W., Ho, C. Y., & Wong, S. Y. S. (2021). Mindfulness-based interventions: an overall review. British medical bulletin, 138(1), 41–57. https://doi.org/10.1093/bmb/ldab005