Mindfulness Training Supports Quality of Life and Advance Care Planning in Adults With Metastatic Cancer and Their Caregivers: Results of a Pilot Study

Overview

Journal Am J Hosp Palliat Care

Publisher Sage Publications

Specialties Critical Care
Nursing

Date 2019 Aug 6

PMID 31378080

Citations 12

Authors

Shelley A Johns

Kathleen Beck-Coon

Patrick V Stutz

Tasneem L Talib

Kelly Chinh

Ann H Cottingham

Karen Schmidt

Cleveland Shields

Madison E Stout

Timothy E Stump

Patrick O Monahan

Alexia M Torke

Paul R Helft

Affiliations

Soon will be listed here.

Abstract

Background: Emotional distress often causes patients with cancer and their family caregivers (FCGs) to avoid end-of-life discussions and advance care planning (ACP), which may undermine quality of life (QoL). Most ACP interventions fail to address emotional barriers that impede timely ACP.

Aim: We assessed feasibility, acceptability, and preliminary effects of a mindfulness-based intervention to facilitate ACP for adults with advanced-stage cancer and their FCGs.

Design: A single-arm pilot was conducted to assess the impact of a 6-week group mindfulness intervention on ACP behaviors (patients only), QoL, family communication, avoidant coping, distress, and other outcomes from baseline (T1) to post-intervention (T2) and 1 month later (T3).

Participants: Eligible patients had advanced-stage solid malignancies, limited ACP engagement, and an FCG willing to participate. Thirteen dyads (N = 26 participants) enrolled at an academic cancer center in the United States.

Results: Of eligible patients, 59.1% enrolled. Attendance (70.8% across 6 sessions) and retention (84.6% for patients; 92.3% for FCGs) through T3 were acceptable. Over 90% of completers reported high intervention satisfaction. From T1 to T3, patient engagement more than doubled in each of 3 ACP behaviors assessed. Patients reported large significant decreases in distress at T2 and T3. Family caregivers reported large significant improvements in QoL and family communication at T2 and T3. Both patients and FCGs reported notable reductions in sleep disturbance and avoidant coping at T3.

Conclusions: The mindfulness intervention was feasible and acceptable and supported improvements in ACP and associated outcomes for patients and FCGs. A randomized trial of mindfulness training for ACP is warranted. The study is registered at ClinicalTrials.gov with identifier NCT02367508 ( https://clinicaltrials.gov/ct2/show/NCT02367508 ).

Citing Articles

Mindfulness to enhance quality of life and support advance care planning: a pilot randomized controlled trial for adults with advanced cancer and their family caregivers.

Mosher C, Beck-Coon K, Wu W, Lewson A, Stutz P, Brown L BMC Palliat Care. 2024; 23(1):232.

PMID: 39342143 PMC: 11439323. DOI: 10.1186/s12904-024-01564-7.

Tools for tomorrow: a scoping review of patient-facing tools for advance care planning.

Riley S, Voisin C, Stevens E, Bose-Brill S, Moss K Palliat Care Soc Pract. 2024; 18:26323524241263108.

PMID: 39045292 PMC: 11265253. DOI: 10.1177/26323524241263108.

The Effect of Internet-delivered Mindfulness Stress Reduction Combined with Acceptance and Commitment Therapy on Health Anxiety and Quality of Life of Caregiver of Patients Infected by COVID-19: A Randomized Clinical Trial.

Shahidi S, Zargar F, Aghaee Khajelangi H, Tarrahi M Int J Community Based Nurs Midwifery. 2023; 11(2):110-121.

PMID: 37114098 PMC: 10126443. DOI: 10.30476/IJCBNM.2023.97271.2172.

A pilot randomized study of a telephone-based cognitive-behavioral stress-management intervention to reduce distress in phase 1 oncology trial caregivers.

Carr A, Bilenduke E, Adolf E, Kessler E, Arch J, Ranby K Palliat Support Care. 2023; 21(5):820-828.

PMID: 36994841 PMC: 10544682. DOI: 10.1017/S1478951523000196.

Effects of a yoga-based stress reduction intervention on stress, psychological outcomes and cardiometabolic biomarkers in cancer caregivers: A randomized controlled trial.

Lee L, Shamburek R, Son H, Wallen G, Cox R, Flynn S PLoS One. 2022; 17(11):e0277009.

PMID: 36355827 PMC: 9648784. DOI: 10.1371/journal.pone.0277009.

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