Mindfulness Workshop for Inpatients in a Cardiothoracic Transplantation Unit

Overview

The Newcastle upon Tyne Hospitals NHS Foundation Trust conducted a pilot programme at Ward 38 in Freeman Hospital’s Cardiothoracic Transplant Centre after identifying a growing need for psychological support among inpatients receiving cardiothoracic transplants. Staff feedback, patient experiences, and clinical observations consistently pointed to elevated levels of distress, anxiety, low mood, and difficulty managing pain during the recovery process. While the existing Psychology service provides vital support for acute mental health needs, it was a limited resource and not always accessible to all patients.

These insights highlighted a pressing need to explore low-intensity, accessible interventions that could be integrated into inpatient care without overburdening existing services. At the same time, there was increasing interest in non-pharmacological approaches to improving well-being during recovery.

Mindfulness, with its evidence base in reducing stress, enhancing mood, and improving pain management, emerged as a promising candidate. This led to the development of a pilot intervention to assess the effectiveness of weekly mindfulness sessions in supporting the psychological well-being of transplant inpatients.

Objectives

The overarching goal of the pilot was to explore the potential of mindfulness as a low-intensity psychological intervention to support cardiothoracic transplant inpatients at Freeman Hospital. Specifically, the present study had three main aims:

1. To understand whether increased access to mindfulness sessions would be beneficial for inpatients.
2. To assess the effectiveness of the sessions in reducing pain, stress, and low mood.
3. To determine whether the sessions were perceived as a positive experience by the patients.

Approach

To explore the impact of mindfulness on the psychological wellbeing of transplant inpatients, a 3-month pilot study was conducted at the Institute of Transplantation, Freeman Hospital, Newcastle Upon Tyne. Mindfulness taster sessions were delivered weekly at Ward 38, a transplant ward inclusive of all organ transplant patients. The intervention was designed to be accessible, low-intensity, and easy to integrate into ward routines.

A mixed methods design with repeated measures was employed to evaluate the impact of each session. Quantitative and qualitative data were collected simultaneously through pre- and post-session questionnaires but analysed separately. Participants were recruited through opportunity sampling. All were over the age of 18 and had received an organ transplant. Although the primary focus was on cardiothoracic transplant recipients, patients who had received other organ transplants were also included to promote inclusivity and support patient equity within the ward environment.  Patients who were on dialysis or too unwell to participate were excluded.

Before launching the intervention, a priori power analysis was conducted using G*Power software to guide sample size requirements. Across the study, 24 participants contributed quantitative data, and 27 participants provided qualitative feedback.

Each session began with participants completing a pre-intervention questionnaire capturing demographic data and ratings of pain, stress, and mood using Visual Analogue Scales (VAS). After listening to a short, pre-recorded mindfulness exercise (either Mindful Breathing or Leaves on the Stream), participants completed a post-intervention questionnaire, which included repeated VAS items, closed questions on session satisfaction, and an open-ended question about their experience. VAS were chosen for their reliability and ease of use in clinical settings, particularly for measuring acute states.

The sessions were delivered by a Clinical Psychologist and lasted around 15–20 minutes. Participation was voluntary, and ethical oversight was obtained through Newcastle University. This structured but low-demand approach enabled the team to assess the real-time psychological effects of mindfulness and gather insights into how the sessions were experienced by the patient group.

Results

The mindfulness pilot delivered positive outcomes for transplant inpatients, with promising findings across both quantitative and qualitative measures. Data collected before and after sessions indicated statistically significant improvements in mood and stress levels, with participants reporting that they felt calmer, more relaxed, and more emotionally settled after just one session. Although reductions in pain were not statistically significant, some patients shared personal accounts of experiencing relief or increased somatic awareness that helped them manage discomfort.

Beyond the data, patient feedback was overwhelmingly positive. Participants described the sessions as “enjoyable,” “soothing,” and “a welcome escape” from the intensity of their treatment journey. Several expressed a desire to continue with mindfulness practices on their own and attend future sessions, highlighting the lasting impression and relevance of the intervention. Even participants who did not experience immediate benefits acknowledged the value of having access to such supportive resources.

Staff also reported a renewed sense of purpose and satisfaction, with psychologists noting increased engagement and curiosity around integrating non-pharmacological wellbeing tools into care. The intervention fostered a more holistic environment on the ward, and its ease of delivery – requiring only 15 minutes and one staff member – made it a feasible addition to routine care. The project also sparked broader conversations among staff about mental health support and patient-centred practices.

Lessons Learnt

One of the most valuable lessons from this pilot was the importance of being flexible and responsive when delivering wellbeing interventions. While the original aim was to evaluate the impact of mindfulness on pain, stress, and mood through measurable outcomes, it quickly became clear that the emotional and subjective experiences of patients were just as important—if not more so—than the data alone.

Another key insight was the variation in how patients responded to mindfulness. Some found the sessions calming and beneficial, while others struggled to engage due to physical discomfort or restlessness. This highlighted that mindfulness is not a one-size-fits-all approach. Future programmes may benefit from offering different techniques and helping patients better understand what to expect.

The pilot also underscored the challenge of working with small sample sizes in a clinical environment. Although early trends were promising, the limited number of participants made it difficult to draw firm conclusions. A larger-scale rollout would be necessary to fully understand the intervention’s impact.

Several practical insights also emerged:

• Live facilitation was strongly preferred over pre-recorded audio, with patients valuing the human connection.
• Printed mindfulness materials offered patients a helpful way to continue practicing independently beyond the session.
• Collaboration with the nursing team was crucial for identifying appropriate participants and ensuring sessions ran smoothly without interfering with medical care.
• While pain reduction was not always significant, patients reported noticeable emotional benefits, including improved mood and a sense of calm.

Finally, this project demonstrated that even simple, low-cost interventions can meet a significant emotional need in inpatient care. Providing patients with a quiet space to breathe and reflect had a powerful effect. The pilot has laid strong groundwork for integrating mindfulness more formally into transplant support, and it opens the door for wider use of psychological wellbeing interventions in hospital settings.

Recommendations

This pilot suggests that mindfulness can positively impact mental distress in transplant inpatients. To build on these findings, future research should use larger sample sizes and explore the effect of repeated versus one-off sessions—particularly in relation to pain and mood (Howarth et al., 2019).

Long-term impact should also be assessed through follow-ups (e.g., one day, one week, and one month post-session), especially for frequent attendees, and compared to a control group. Broader outcomes such as treatment adherence, lifestyle behaviours, and recovery patterns should be explored to understand wider benefits.

Key considerations for future implementation:

• Start small, scale later – Simple, low-intensity approaches can still have impact.
• Use mixed methods – Combine data and personal feedback to measure success.
• Be flexible – Rotate mindfulness techniques to suit different patient needs. This may increase accessibility and engagement.
• Work collaboratively – Involve ward staff and Psychology teams early.
• Favour live delivery – Patients prefer in-person facilitation over recordings.
• Encourage self-care – Provide printed resources for continued practice.
• Plan for follow-up – Assess medium- and longer-term outcomes to strengthen the evidence base.

Even short, low-cost mindfulness sessions can offer meaningful support and should be considered as part of stepped psychological care in hospital settings.

Contact Information

Dr E. Lucy Attenborough, Programme Lead/ Clinical Psychologist, Newcastle upon Tyne Hospitals NHS Foundation Trust, Email: lucy.attenborough@nhs.net