Introduction: Burn pruritus is one of the most unbearable disturbances during the rehabilitation period, which could last for years after the burn incident. This study aimed to investigate the effect of mindfulness-based stress reduction (MBSR) in burn patients, and to propose a psychological model for burn pruritus, which contains a vicious cycle and a recovery process.
Methods: Study 1 is a longitudinal study with three time points for data collection. Participants of MBSR group (n = 12) and control group (n = 21) completed assessments at baseline, 2 months, and 4 months after baseline. Burn pruritus, negative emotions, sleep quality and mindfulness were measured. To analyze the data, t test and hierarchical regression were used. Study 2 is a cross-sectional study (n = 83), examining the proposed psychological model for burn pruritus. Sensitivity to itch, itch related cognitive appraisal, negative emotions, sleep quality, itch consequences, mindfulness and acceptance to chronic pruritus were measured. To analyze the data, hierarchical regression and multiple serial mediation analyses were conducted.
Results: In study 1, no significant differences were found between MBSR and control group in mindfulness, negative emotions, and sleep quality level at baseline, 2 months, and 4 months after baseline. In study 2, multiple serial mediation analyses confirmed the bidirectional vicious cycle and unidirectional of the recovery path of burn itch. In addition, mindfulness moderated the relationship between sensitivity to itch and acceptance to chronic itch.
Conclusion: Mindfulness and acceptance to chronic pruritus has a buffering effect on itch related attention and cognition, which could lead to better itch consequences, less negative emotion, and less sleep disturbances. Nevertheless, MBSR needs further modification to tailor to burn patients.