Phase I: Preparation BRIEFLY identify and define the clinical problem or controversy in your
nursing interest or expertise area. (3 points)
Migraine poses a significant health challenge and burden of disease for affected populations.
The condition is the second leading cause of disability globally, with an estimated 67% of
patients with migraine discontinuing medications due to reported adverse effects and treatment
inefficacy (Wells et al., 2021). If left untreated or inadequately addressed, migraine can
significantly reduce a person’s quality of life due to the pain and disruption of activities of daily
life. In such a case, the prevalence of migraine-related headaches is estimated at 15%. Mindful based interventions are widely applied in addressing migraines. Examples include mindfulness based cognitive therapy for migraine (MBCT-M) (Seng et al., 2019), mindfulness-based
meditation, headache education (Wells et al., 2021), and distraction (Wachholtz et al., 2019).
Nonetheless, the effectiveness of such approaches depends on patient-specific factors. The
absence of a standardized prescription system and duration results in poor adherence and
related lack of efficacy for affected individuals. In such as case, there is a need to assess further
the application of mindfulness-based interventions (MBI) in reducing pain for individuals with
migraine to enhance treatment uptake and adoption.
Phase II: Synthesize the Evidence/Review of the Literature (based upon the three articles
that you selected and cited in your computerized Review of the Literature and Table of Evidence
assignments for this class (use ONLY the space provided – HINT: be succinct!) (10 points)
Seng et al. (2019. MBCT-M was significant in addressing migraine pain in affected patients.
Subsequently, in a randomized controlled trial, the mean MIDI score for the MBCT-M group was
reduced to -0.6/10 compared to the waitlist or treatment as usual, with an increase of +0.3/10 at
p= 0.007. However, the pain and time variables did not substantially affect migraine. Severe
disability caused by migraine-related headaches fell from 88.3% at the beginning of the
intervention to 66.7% in the fourth month in all groups.
Wells et al. (2021). Compared to headache education, the primary outcome was mindfulnessbased stress reduction (MBSR). Subsequently, at week 12, the MBSR group reported -1.6
migraine days monthly at 95% CI, while the headache education group experienced -2.0
migraine days monthly at 95% CI and p=0.5. The outcome suggested no substantial variance
between the two cohorts. However, the MBSR cohort had better results related to incapacity,
quality of life, autonomy, pain, depression levels, and pain strength and associated
unpleasantness than the headache education group.
Wachholtz et al. (2019). The study significantly decreased migraine-caused pain (p= 0.002) and
anger (p= 0.005) for the cognitively active group. In such a case, the cognitively active
intervention was more effective in eliminating pain and mood disorders caused by migraine pain
in the long term. However, the intervention is helpful in the long term, with the most benefits
observed in patients using the treatment for more than 20 days.
Phase III: Comparative Evaluation Phase
A. Fit of Setting – Are these solutions appropriate or inappropriate for an outpatient OB/GYN
clinic? Why or why not? (include comments on sample, methodology, instrumentation, and
design) (7 points)
The solutions are appropriate for an outpatient population. Subsequently, Seng et al. (2019)
incorporated a sample from the broader New York area. Moreover, the sample (n= 60) was fully
employed in a randomized clinical trial. Additionally, the emphasis on individuals affected by
episodic and chronic migraine illustrates the intervention’s applicability in outpatient care,
