Ramachandra, P., Booth, S., Pieters, T., Vrotsou, K., & Huppert, F.A. (2009). A brief self-administered psychological intervention to improve well-being in patients with cancer: Results from a feasibility study. Psycho-Oncology, 18, 1323–1326.
DOI Link
Study Purpose
To develop a brief, cost-effective, self-administered psychological intervention to improve well-being by using positive psychology and mindfulness meditation
Intervention Characteristics/Basic Study Process
Authors recruited for the study were patients with stable metastatic breast cancer or prostate cancer who had at least a six-month life expectancy. Patients were randomized into an immediate treatment group and a wait-list control. All participants had follow-up at 6, 12, and 18 weeks. The intervention consisted of keeping a well-being diary, using a CD with a 10-minute recording to complete a mindfulness body scan, and planning a pleasurable activity.
Sample Characteristics
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The sample was composed of 27 participants with metastatic breast or prostate cancer.
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Mean age of women was 60.8 years; mean age of men was 72.4 years.
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Of female participants, 13 were in the analysis phase; of males, 14 were in the analysis phase.
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A stable life expectancy greater than 6 months was a condition of inclusion. Patients with a psychiatric diagnosis were included if the condition was diagnosed as stable.
Setting
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Single site
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Outpatient
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Cambridge, Cambridgeshire, England
Phase of Care and Clinical Applications
Active treatment and transition
Study Design
Randomized controlled trial
Measurement Instruments/Methods
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World Health Organization Quality of Life Instrument-BREF (WHOQOL-BREF)
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Hospital Anxiety and Depression Scale (HADS)
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Social and Occupational Functioning Assessment Scale (SOFAS)
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Life Orientation Test, Revised (LOT-R)
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Ten Item Personality Inventory (TIPI)
Results
Positive qualitative feedback reflected a statistically significant (p = 0.046) improvement in quality of life. Although HADS scores improved after the intervention, the change was not significant, and SOFAS scores did not change significantly. Adherence to the intervention was 67% for CD listening, 71% for writing in the diary, and 46% for activity planning.
Conclusions
The intervention was associated with some improvement in quality-of life-measures, but there was no effect on depression or anxiety.
Limitations
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The study had a small sample size, with fewer than 30 participants and a high attrition rate.
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The study had risk of bias due to no blinding.
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Measures of internal consistency reliability for the instruments were not reported.
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Follow-up occurred by different methods: in the clinic, at home, via telephone, or by means of a mailed survey.
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Patients complained of repetitiveness in the diary-writing aspect of the intervention. They study did not include analysis of patient adherence to or actual use of the approach.
Nursing Implications
Findings do not indicate that mindfulness-based intervention, as used in this study, had an impact on well-being.