Patients' experiences of a mindfulness intervention for adults with advanced cancer: a qualitative analysis

Clinical application of mindfulness in end-of-life care from the perspective of palliative care professionals: A phenomenological study

BACKGROUND

and Purpose: With mindfulness being increasingly recognized for its potential to address psychological challenges related to advanced or terminal illnesses, palliative care professionals are incorporating mindfulness-based interventions into their practice. However, there is limited understanding of the practical applications of mindfulness in clinical settings, particularly for end-of-life patients. This study explored palliative care professionals' experiences in delivering mindfulness-based therapy to end-of-life patients, thereby aiming to inform the development of effective interventions.

MATERIALS AND METHODS

Semi-structured interviews were conducted with 15 palliative care professionals. Participants were asked to describe their memorable experiences in applying mindfulness in a clinical setting. Data were analyzed following Moustakas's transcendental phenomenology approach.

RESULTS

The interviews produced three themes: clinicians' mindfulness experiences form the cornerstone of their clinical application of mindfulness; creating an optimal healing environment is essential for mindfulness practice; and patient-centric mindfulness guidance should be implemented.

CONCLUSION

This study underscores the critical role of mindfulness in end-of-life care, highlighting its integration into daily life by palliative care professionals. By drawing upon their own mindfulness experiences, palliative care professionals facilitated a therapeutic environment tailored to the unique needs of end-of-life patients. This patient-centered approach not only enhanced the quality of care but also fostered a healing connection rooted in compassion and empathy. The findings advocate for further education and development of mindfulness-based interventions, including group therapies, to support the holistic well-being of patients in collectivist cultures. Future research should further explore the practical applications and benefits of mindfulness in end-of-life care settings.

The impact of mindfulness-based interventions on the experiences of cancer patients: A qualitative meta-synthesis

OBJECTIVE

This study analyzed qualitative research to explore cancer patients' perspectives on MBIs, including benefits, challenges, and recommendations.

METHODS

This systematic review focused on synthesizing qualitative data and was registered with PROSPERO under the protocol registration number xxx. Searched 7 databases for qualitative studies on MBIs & cancer patients (17 studies, 365 patients). Analyzed data using themes & assessed confidence in findings.

RESULTS

Thematic analysis using NVivo software revealed four significant themes: (1) benefits and positive outcomes (e.g., symptom improvement, team support, positive experiences), (2) challenges and difficulties (e.g., practice challenges, negative experiences), (3) the journey of change and acceptance (e.g., shifts in perception, personal growth, and acceptance), and (4) adaptations and recommendations (e.g., program modification and flexibility).

CONCLUSION

Mindfulness-based interventions have the potential to offer cancer patients positive emotional experiences, increased team support, and opportunities for personal growth, self-discovery, and acceptance. This, in turn, can help them manage the psychological distress associated with cancer. Customizing programs to align with individual patients' needs and preferences can enhance engagement and effectiveness.

PRACTICE IMPLICATIONS

Integrating MBIs into Patient Education and Counseling, tailored to individual needs and with ongoing support, can enhance cancer care. Group interventions foster peer support and effectiveness. Training providers and ensuring accessibility are crucial. Research and customization to patients' journeys optimize outcomes and satisfaction. A patient-centered approach is essential for positive experiences and improved clinical outcomes.

Death education interventions for people with advanced diseases and/or their family caregivers: A scoping review

BACKGROUND

People with life-threatening diseases and their family caregivers confront psychosocial and spiritual issues caused by the persons' impending death. Reviews of death education interventions in the context of life-threatening diseases are scarce and limited to certain intervention types.

AIMS

This study aims to ascertain existing evidence on death education interventions for the population of adults with advanced diseases and/or their family caregivers and identify gaps for future research.

DESIGN

A scoping review guided by Arksey and O'Malley's framework.

DATA SOURCES

Thirteen electronic databases were searched for experimental and qualitative studies on death education interventions for the advanced disease population and/or their family caregivers between 1 January 1960 and 25 October 2023.

RESULTS

Nine types of interventions were identified in 47 studies, which included 5 qualitative and 42 experimental designs, half of which were pilot and feasibility trials. Most of the studies focused on people with advanced cancer, and only seven investigated caregivers or families/couples. Death-related outcomes were less likely to be assessed relative to psychological outcomes, spiritual well-being, and quality of life. Life review interventions, cognitive-behavior therapy, narrative therapy, and general psychosocial interventions decreased depression and anxiety, but evidence was limited. Factors contributing to the interventions' success included intervention content, which enabled the disclosure of personal experience and death concerns comfortably, trained professionals, and connection to family caregivers.

CONCLUSIONS

This work identified a few potentially effective death education interventions for psychological outcomes for people with advanced cancer or their caregivers. Additional trials are needed to confirm the effectiveness of these interventions.

The experience of a program combining two complementary therapies for women with breast cancer: An IPSE qualitative study

INTRODUCTION

The use of complementary therapies within oncology is a clinical issue, and their evaluation a methodological challenge. This paper reports the findings of a qualitative study exploring the lived experience of a French program of complementary therapies combining structured physical activity and MBSR among women with breast cancer.

METHODS

This French exploratory qualitative study followed the five stages of the Inductive Process to analyze the Structure of lived Experience (IPSE) approach. Data was collected from February to April 2021 through semi structured interviews. Participants, purposively selected until data saturation. Inclusion criteria were: being an adult woman with breast cancer whatever the stage who had completed their treatment and were part of the program of complementary therapies.

RESULTS

29 participants were included. Data analysis produced a structure of experience based on two central axes: 1) the experience these women hoped for, with two principal expectations, that is to take care of their bodies and themselves, and to become actors in their own care; and 2) an experience of discovery, first of themselves and also in their relationship with the exterior, whether with others, or in society, and in the relationships with health-care providers.

CONCLUSIONS

Our results from this French study reinforce the data described in other western countries about the needs of women receiving care in oncology departments for breast cancer: they need to be informed of the existence of supportive care in cancer by the health-care professionals themselves, to be listened to, and to receive support care. A systematic work of reflexivity about this redundancy in our results and in the qualitative literature, led us to question what impeded the exploration of more complex aspects of the experience of this women-the inherently emotional and anxiety-inducing experience of cancer, especially anxiety about its recurrence and of death-and to suggest new research perspectives to overcome these methodological and theoretical obstacles.

Core values of patients with advanced cancer considering participation in an early-phase clinical trial: a qualitative study

OBJECTIVE

This article identifies the core values that play a role in patients' decision-making process about participation in early-phase clinical cancer trials.

METHODS

Face-to-face, semi-structured serial interviews (n = 22) were performed with thirteen patients with advanced cancer recruited in two Dutch specialized cancer centers. In a cyclic qualitative analysis process, open and axial coding of the interviews finally led to an overview of the values that are woven into patients' common language about cancer and clinical trials.

RESULTS

Six core values were described, namely, acceptance creates room for reconsideration of values, reconciliation with one's fate, hope, autonomy, body preservation, and altruism. Previously found values in advanced cancer, such as acceptance, hope, autonomy, and altruism, were further qualified. Reconciliation with one's fate and body preservation were highlighted as new insights for early-phase clinical cancer trial literature.

CONCLUSIONS

This article furthers the understanding of core values that play a role in the lives and decision-making of patients with advanced cancer who explore participation in early-phase clinical cancer trials. These values do not necessarily have to be compatible with one another, making tragic choices necessary. Understanding the role of core values can contribute to professional sensitivity regarding what motivates patients' emotions, thoughts, and decisions and help patients reflect on and give words to their values and preferences. It supports mutual understanding and dialog from which patients can make decisions according to their perspectives on a good life for themselves and their fellows in the context of participation in an early-phase clinical cancer trial.

Effectiveness of mindfulness-based art therapy for symptoms of anxiety, depression, and fatigue: A systematic review and meta-analysis

BACKGROUND AND PURPOSE

Many people with chronic medical conditions experience symptoms that are complex and negatively impact their quality of life (QOL). This review and meta-analysis examined the benefits of mindfulness based art therapy (MBAT) to relieve symptoms.

METHODS

Included were studies that (a) evaluated an MBAT intervention in adults, (b) included a sufficient effect size and control group, and (c) assessed symptoms and QOL outcomes.

RESULTS

Fourteen studies sampling adolescents and adults met inclusion criteria. Participants who received MBAT interventions reported significant improvements in psychological and physical symptoms indices compared to controls; the meta-analysis MBAT interventions revealed a medium effect size whereas that for controls the effect size was equivalent to zero.

CONCLUSION

MBAT is a promising intervention for symptom relief. However, the literature is limited by the small number of studies. Randomized controlled trials with larger samples are needed to validate findings.