Psychosocial Outcomes in Hand Therapy

Rationale: there is a need for psychosocial symptom management in hand therapy which has been
understudied. Mindfulness-based interventions are used to address psychosocial symptoms in
other settings such as chronic injury but have yet to be implemented or explored for patients
in acute outpatient rehabilitation.

Intervention: a supplemental mindfulness-based intervention (MBI) will be provided to the
experimental group while the control group will receive standard care. The MBI will begin
with an explanation of the purpose of a mindfulness, how mindfulness relates to hand therapy,
and lead to a 20-minute guided meditation using an audio recording.

Objectives: to establish the feasibility of providing a MBI in hand therapy and evaluate
preliminary effects of the MBI on patients' stress, anxiety, and depression.

Population: adult patients at an outpatient hand therapy clinic in the Los Angeles area who
have received a traumatic injury (e.g., tendon laceration, compound fracture, finger
amputation).

Methodology: the study will use a mixed-methods, non-randomized, 2-group, comparative trial
design with 40 participants in total. Quantitative data on psychosocial outcomes, including
salivary cortisol, will be collected once a week for 4 weeks while patients are attending
hand therapy and qualitative interviews will be conducted at the end of the study.

Study arms: the experimental group (n = 20) will receive the MBI just before regularly
scheduled standard care visits. The control group (n = 20) will receive only standard care.

Outcomes: this pilot study will be used to inform a future fully powered trial on
mindfulness-based interventions in hand therapy. Feasibility and preliminary psychosocial
effects of MBIs will be evaluated and used to inform future work.

Analysis: (1) A repeated measures ANOVA for intervention group, time, and time by
intervention group effects on the psychosocial outcomes (i.e., Cortisol, Anxiety, Depression,
and Pain Catastrophizing). (2) A descriptive qualitative process will be used to analyze
themes in participant interview responses.