Cancer

Spirituality Improves Posttraumatic Growth with Mothers of Children with Cancer

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Spirituality Improves Posttraumatic Growth with Mothers of Children with Cancer

 

By John M. de Castro, Ph.D.

 

“spirituality can play a critical role in the way traumas are understood, how they are managed, and how they are ultimately resolved.” – Kenneth Pargamen

 

Modern living is stressful under the best of conditions. But dealing with the trauma of having a child with cancer the levels of stress and anxiety are markedly increased. It is important for people to engage in practices that can help them control their responses to the stress and their levels of anxiety. Spirituality, a sense of inner peace and harmony, and religiosity are known to help with a wide range of physical and psychological problems. It is not known if spirituality affects the symptoms or posttraumatic growth produced by the trauma of having a child with cancer.

 

In today’s Research News article “Posttraumatic Growth and Spirituality in Mothers of Children with Pediatric Cancer.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7999482/ ) Czyżowska and colleagues recruited mothers of children (average age of 6.4 years) who were in the hospital being treated for cancer. They completed measures of post-traumatic growth, including changes in self-perception, changes in relationships with others, appreciation of life, and spiritual changes; and spirituality including religious attitudes, ethical sensitivity, and harmony.

 

They found that the higher the levels of spirituality, including ethical sensitivity, and harmony, the higher the levels of post-traumatic growth including relationships with others, and spiritual changes. The highest levels of post-traumatic growth that the mothers had were in in appreciation of life. In addition, the mothers with the greatest changes in post-traumatic growth had significantly higher levels of spirituality.

 

These results suggest that mothers of children with pediatric cancer demonstrate post-traumatic growth, especially in appreciation of life. In addition, they found that this post-traumatic growth was associated with spirituality. It is interesting that religious attitudes were not associated with growth. Hence, having inner peace and harmony (spirituality) and not religiosity is associated with growth. This raises the possibility that treating mothers’ spirituality may assist them in coping with pediatric cancer. Being better able to cope with the stresses should allow the mothers to better work with their children, promoting their health and well-being.

 

So, spirituality improves posttraumatic growth with mothers of children with cancer.

 

“positive religious coping, religious openness, readiness to face existential questions, religious participation, and intrinsic religiousness are typically associated with posttraumatic growth.” – Annick Shaw

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Czyżowska, N., Raszka, M., Kalus, A., & Czyżowska, D. (2021). Posttraumatic Growth and Spirituality in Mothers of Children with Pediatric Cancer. International Journal of Environmental Research and Public Health, 18(6), 2890. https://doi.org/10.3390/ijerph18062890

 

Abstract

A child’s cancer, as a life-threatening illness, is classified as a traumatic event both for the child him-/herself and for his/her relatives. Struggling with a traumatic experience can bring positive consequences for an individual, which is referred to as posttraumatic growth. The aim of this study was to explore the relationship between posttraumatic growth and spirituality understood as a personal resource in mothers of children with pediatric cancer. In total, 55 mothers whose children were in the phase of treatment and who had been staying with them in the hospital filled in a Posttraumatic Growth Inventory, Self-description Questionnaire of Spirituality, and the author’s short questionnaire on demographic variables and information on the child and his/her disease. A high level of posttraumatic development, especially in the area of life appreciation, was observed in the examined mothers. Spirituality was positively related to the emergence of positive change, in two particular components, ethical sensitivity and harmony. It seems that taking into account the area of spirituality when planning interventions and providing support in this group could foster coping with the situation and emergence of posttraumatic growth.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7999482/

 

Tai Chi Practice Improves the Symptoms of Multiple Diseases

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Tai Chi Practice Improves the Symptoms of Multiple Diseases

 

By John M. de Castro, Ph.D.

 

“In addition to easing balance problems, and possibly other symptoms, tai chi can help ease stress and anxiety and strengthen all parts of the body, with few if any harmful side effects.” Peter Wayne

 

Tai Chi is an ancient mindfulness practice involving slow prescribed movements. It is gentle and completely safe, can be used with the elderly and sickly, is inexpensive to administer, can be performed in groups or alone, at home or in a facility or even public park, and can be quickly learned. In addition, it can also be practiced in social groups without professional supervision. This can make it fun, improving the likelihood of long-term engagement in the practice. Indeed, studies have shown that Tai Chi practice is effective in improving the symptoms of many different diseases. The evidence is accumulating. So, it makes sense to step back and summarize what has been learned about the effectiveness of different Tai Chi practices for different disease conditions.

 

In today’s Research News article “.Clinical Evidence of Tai Chi Exercise Prescriptions: A Systematic Review” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7972853/ ) Huang and colleagues review and summarize the published randomized controlled trials on the effectiveness of different Tai Chi practices for different disease conditions. They identified 139 published randomized controlled trials utilizing a number of different Tai Chi styles and numbers of forms. Yang style was by far the most frequent style and 24 forms was the most frequent number of forms employed.

 

They report that the published research found that Tai Chi practice produced significant improvement in the symptoms of musculoskeletal system or connective tissue diseases such as osteoarthritis, fibromyalgia, and chronic low back pain.; on circulatory system diseases such as hypertension, stroke, coronary heart disease, and chronic heart failure; on mental and behavioral disorders such as depression, cognitive impairment, and intellectual disabilities; on nervous system diseases such as Parkinson’s disease, dementia, and sleep disorders; on chronic obstructive pulmonary disease (COPD); on endocrine, nutritional, or metabolic diseases such as type 2 diabetes and metabolic syndrome; on the physical and mental state of cancer patients, and on traumatic brain injury and urinary tract disorders; on balance control and flexibility and falls in older adults.

 

These are remarkable findings. Tai Chi practice appears to be a safe and effective treatment for the symptoms of a wide variety of diseases. It doesn’t cure the disease. Rather if alleviates the symptoms. It is not known the mechanisms by which Tai Chi has these benefits. Future research needs to further explore what facets or effects of Tai Chi practice are responsible for the disease symptom improvements.

 

So, Tai Chi practice improves the symptoms of multiple diseases.

 

“Tai Chi and Qigong are evidence-based approaches to improve health-related quality of life, and they may be effective for a range of physical health conditions.” – Ryan Abbott

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Huang, J., Wang, D., & Wang, J. (2021). Clinical Evidence of Tai Chi Exercise Prescriptions: A Systematic Review. Evidence-based Complementary and Alternative Medicine : eCAM, 2021, 5558805. https://doi.org/10.1155/2021/5558805

 

Abstract

Objectives

This systematic review aims to summarize the existing literature on Tai Chi randomized controlled trials (RCTs) and recommend Tai Chi exercise prescriptions for different diseases and populations.

Methods

A systematic search for Tai Chi RCTs was conducted in five electronic databases (PubMed, Cochrane Library, EMBASE, EBSCO, and Web of Science) from their inception to December 2019. SPSS 20.0 software and Microsoft Excel 2019 were used to analyze the data, and the risk of bias tool in the RevMan 5.3.5 software was used to evaluate the methodological quality of RCTs.

Results

A total of 139 articles were identified, including diseased populations (95, 68.3%) and healthy populations (44, 31.7%). The diseased populations included the following 10 disease types: musculoskeletal system or connective tissue diseases (34.7%), circulatory system diseases (23.2%), mental and behavioral disorders (12.6%), nervous system diseases (11.6%), respiratory system diseases (6.3%), endocrine, nutritional or metabolic diseases (5.3%), neoplasms (3.2%), injury, poisoning and certain other consequences of external causes (1.1%), genitourinary system diseases (1.1%), and diseases of the eye and adnexa (1.1%). Tai Chi exercise prescription was generally classified as moderate intensity. The most commonly applied Tai Chi style was Yang style (92, 66.2%), and the most frequently specified Tai Chi form was simplified 24-form Tai Chi (43, 30.9%). 12 weeks and 24 weeks, 2-3 times a week, and 60 min each time was the most commonly used cycle, frequency, and time of exercise in Tai Chi exercise prescriptions.

Conclusions

We recommend the more commonly used Tai Chi exercise prescriptions for different diseases and populations based on clinical evidence of Tai Chi. Further clinical research on Tai Chi should be combined with principles of exercise prescription to conduct large-sample epidemiological studies and long-term prospective follow-up studies to provide more substantive clinical evidence for Tai Chi exercise prescriptions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7972853/

 

The Well-Being and Quality of Life in Cancer Patients are Related to Spirituality

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The Well-Being and Quality of Life in Cancer Patients are Related to Spirituality

 

By John M. de Castro, Ph.D.

 

“Many patients with cancer rely on spiritual or religious beliefs and practices to help them cope with their disease. This is called spiritual coping.” – National Cancer Institute

 

A cancer diagnosis has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing experience. These feeling can result from changes in body image, changes to family and work roles, feelings of grief at these losses, and physical symptoms such as pain, nausea, or fatigue. People might also fear death, suffering, pain, or all the unknown things that lie ahead. So, coping with the emotions and stress of a surviving cancer is a challenge and there are no simple treatments for these psychological sequelae of cancer.

 

Religion and spirituality become much more important to people when they survive cancer. It is thought that people take comfort in the spiritual when facing mortality. Hence, spirituality may be useful for cancer patients to cope with their illness and the psychological difficulties resulting from the disease. Thus, there is a need to study the relationships of spirituality on the well-being and quality of life of cancer patients.

 

In today’s Research News article “Association between spiritual well-being, quality of life, anxiety and depression in patients with gynecological cancer in China.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7793354/) Chen and colleagues recruited women with primary gynecological cancer and had them complete measures of quality of life with cancer, global health, spiritual well-being, anxiety, and depression.

 

They found that the higher the levels of spiritual well-being the higher the levels of global health and quality of life and the lower the levels of depression and anxiety. Multiple regression analysis revealed that religion, depression, anxiety and quality of life were the strongest predictors of spiritual well-being.

 

These findings are correlational and as a result causation cannot be determined. Regardless, the results clearly show that spiritual well-being is significantly related to better health and quality of life and lower psychological problems in women with primary gynecological cancer. These findings are similar to those seen with other forms of cancer that spirituality is associated with the patient’s quality of life and well-being. This raises the possibility that promoting spirituality in cancer patients may improve their physical and psychological well-being. It remains for future research to explore this possibility.

 

So, the well-being and quality of life in cancer patients are related to spirituality.

 

“Consistent associations between spirituality, spiritual well-being, and health outcomes found in published studies highlight the importance of providing spiritual care to enhance cancer patients’ spiritual well-being and address their spiritual needs.” – Yi-Hui Lee

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Chen, J., You, H., Liu, Y., Kong, Q., Lei, A., & Guo, X. (2021). Association between spiritual well-being, quality of life, anxiety and depression in patients with gynaecological cancer in China. Medicine, 100(1), e24264. https://doi.org/10.1097/MD.0000000000024264

 

Abstract

The physical and psychological condition of patients with gynaecological cancer has received much attention, but there is little research on spirituality in palliative care. This study aimed to investigate spiritual well-being and its association with quality of life, anxiety and depression in patients with gynaecological cancer. A cross-sectional study was conducted in China in 2019 with 705 patients diagnosed with primary gynaecological cancer. European Organisation for Research and Treatment of Cancer quality of life instruments (EORTC QLQ-SWB32 and EORTC QLQ-C30) and the Hospital Anxiety and Depression Scale were used to measure spiritual well-being, quality of life, anxiety and depression. Univariate and multiple linear regression analyses were performed to examine associations between spiritual well-being, quality of life, anxiety and depression. Functioning scales and global health status were positively correlated with spiritual well-being (P < .05). Anxiety and depression were negatively correlated with spiritual well-being (P < .05). Depression (−0.362, P < .001) was the strongest predictor of Existential score. Anxiety (−0.522, P < .001) was the only predictor of Relationship with self. Depression (−0.350, P < .001) and Global health (0.099, P = .011) were the strongest predictors of Relationship with others. Religion (−0.204, P < .001) and Depression (−0.196, P < .001) were the strongest predictors of Relationship with someone or something greater. Global health (0.337, P < .001) and Depression (−0.144, P < .001) were the strongest predictors of Global-SWB. Well spiritual well-being is associated with lower anxiety and depression, and better quality of life. Health providers should provide more spiritual care for non-religious patients and combine spiritual care with psychological counselling to help patients with gynaecological cancer, especially those who have low quality of life or severe symptoms, or experience anxiety or depression.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7793354/

 

Improve Physical and Mental Well-Being with Mindfulness Meditation-Based Interventions

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Improve Physical and Mental Well-Being with Mindfulness Meditation-Based Interventions

 

By John M. de Castro, Ph.D.

 

“mindfulness meditation is related to improved mental health across a variety of disorders, including different anxiety disorders, depression, eating disorders, substance abuse, and chronic pain symptom reduction.” – Jennifer Wolkin

 

Over the last several decades, research and anecdotal experiences have accumulated an impressive evidential case that the development of mindfulness has positive benefits for the individual’s mental, physical, and spiritual life. Mindfulness appears to be beneficial both for healthy people and for people suffering from a myriad of mental and physical illnesses. It appears to be beneficial across ages, from children to the elderly. And it appears to be beneficial across genders, personalities, race, and ethnicity. The breadth and depth of benefits is unprecedented. There is no other treatment or practice that has been shown to come anyway near the range of mindfulness’ positive benefits.

 

Over the last few decades, a vast amount of research has been published on the benefits of mindfulness practices on the mental and physical health of the practitioners. Many reviews, summarizations, and meta-analyses have been performed of these studies. So, it makes sense to step back and summarize what these meta-analyses have found.

 

In today’s Research News article “The empirical status of mindfulness-based interventions: A systematic review of 44 meta-analyses of randomized controlled trials.” (See summary below or view the full text of the study at: https://centerhealthyminds.org/assets/files-publications/Goldberg-the-empirical-status.pdf ) Goldberg and colleagues review, summarize, and perform a meta-analysis of previous meta-analyses of published randomized controlled studies on benefits of sustained meditation practices on mental and physical well-being. They identified 44 published meta-analyses, representing 336 randomized controlled trials, which included a total of 30,483 participants.

 

They report that the meta-analyses of published randomized controlled trials found that sustained mindfulness meditation practices in comparison to passive, no treatment, controls had a very wide range of beneficial effects across a wide range of participants from children to the elderly, over a variety of programs from Mindfulness-Based Stress Reduction (MBSR) to mobile health, over a variety of psychological issues from anxiety to psychoses, and over a wide range of diseases from chronic pain to cancer. These effects were present immediately post treatment and at later follow-ups (an average of 7 months after treatment).

 

Comparison of these mindfulness meditation practices to active control conditions such as attentional controls to evidence-based treatments, resulted in reduced effect sizes and many were non-significant. Mindfulness meditation practices had significantly superior effects than active controls for adults, children, employees, and health care professionals/trainees but not for students. They were superior for psychiatric disorders, substance use, smoking, and depression but not for physical health conditions, pain, weight/eating-related conditions, cancer, or anxiety. They were superior for stress, and psychiatric symptoms but not for sleep, physical health symptoms, objective measures, or physiological measures.

 

These findings are essentially summaries of summaries and are based upon a wide variety of different researchers, methodologies, cultures, and time frames. Yet, the results are fairly consistent. In comparison to doing nothing, passive controls, mindfulness meditation practices are very beneficial for a wide range of physical and psychological issues over a wide range of ages. But these practices when compared to other types of treatments, are less effective and at times not superior. Nevertheless, this meta-analysis of meta-analyses paints a clear picture of the wide-ranging efficacy of mindfulness meditation practices for the relief of physical and psychological issues. These results verify the unprecedented depth and breadth of benefits of mindfulness meditation practices.

 

So, improve physical and mental well-being with mindfulness meditation-based interventions.

 

“Practicing mindfulness exercises can have many possible benefits, including: reduced stress, anxiety and depression, less negative thinking and distraction, and improved mood,” -Mayo Clinic

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Goldberg, S. B., Riordan, K., Sun, S., & Davidson, R. J. (2021). The empirical status of mindfulness-based interventions: A systematic review of 44 meta-analyses of randomized controlled trials. Perspectives on Psychological Science 1–23, DOI: 10.1177/1745691620968771

 

Abstract

In response to questions regarding the scientific basis for mindfulness-based interventions (MBIs), we evaluated their empirical status by systematically reviewing meta-analyses of randomized controlled trials (RCTs). We searched six databases for effect sizes based on ≥4 trials that did not combine passive and active controls. Heterogeneity, moderators, tests of publication bias, risk of bias, and adverse effects were also extracted. Representative effect sizes based on the largest number of studies were identified across a wide range of populations, problems, interventions, comparisons, and outcomes (PICOS). A total of 160 effect sizes were reported in 44 meta-analyses (k=336 RCTs, N=30,483 participants). MBIs showed superiority to passive controls across most PICOS (ds=0.10-0.89). Effects were typically smaller and less often statistically significant when compared to active controls. MBIs were similar or superior to specific active controls and evidence-based treatments. Heterogeneity was typically moderate. Few consistent moderators were found. Results were generally robust to publication bias, although other important sources of bias were identified. Reporting of adverse effects was inconsistent. Statistical power may be lacking in meta-analyses, particularly for comparisons with active controls. As MBIs show promise across some PICOS, future RCTs and meta-analyses should build upon identified strengths and limitations of this literature.

https://centerhealthyminds.org/assets/files-publications/Goldberg-the-empirical-status.pdf

 

Improve Psychological Well-Being in Cancer Survivors with Online Mindfulness-Based Cognitive Therapy (MBCT)

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Improve Psychological Well-Being in Cancer Survivors with Online Mindfulness-Based Cognitive Therapy (MBCT)

 

By John M. de Castro, Ph.D.

 

“both MBCT and eMBCT interventions reduced fear of cancer recurrence and rumination, and increased mental health–related quality of life, mindfulness skills, and positive mental health.” – Félix Compen

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. These feeling can result from changes in body image, changes to family and work roles, feelings of grief at these losses, and physical symptoms such as pain, nausea, or fatigue. People might also fear death, suffering, pain, or all the unknown things that lie ahead. So, coping with the emotions and stress of a cancer diagnosis is a challenge and there are no simple treatments for these psychological sequelae of cancer diagnosis.

 

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including fatigue, stress,  sleep disturbance, fear, and anxiety and depression. Mindfulness-Based Cognitive Therapy (MBCT) is a well-established therapy that involves mindfulness training and cognitive therapy to change maladaptive thought processes. MBCT has been found to be effective in reducing the residual psychological issues that are common in cancer survivors.

 

But the vast majority of the mindfulness training techniques require a trained therapist. This results in costs that many parents can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with parents’ busy schedules and at locations that may not be convenient. As an alternative, mindfulness trainings over the internet have been developed. These have tremendous advantages in making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. So, it makes sense to explore the effectiveness of internet-based Mindfulness-Based Cognitive Therapy (iMBCT) in treating the psychological symptoms of cancer survivors.

 

In today’s Research News article “Internet-delivered Mindfulness-Based Cognitive Therapy for anxiety and depression in cancer survivors: Predictors of treatment response.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7843453/ )  Nissen and colleagues recruited adult breast and prostrate cancer survivors and randomly assigned them to a wait-list control condition or to receive internet-based Mindfulness-Based Cognitive Therapy (iMBCT); consisting of 8 1-week modules. They were measured before and after training and 6 months later for mindfulness, self-compassion, anxiety, depression, and therapy related working reliance.

 

They found that at baseline the higher the levels of self-compassion and the mindfulness facets of describing, non-judging, and acting with awareness, the lower the levels of anxiety and depression. Mindfulness-Based Cognitive Therapy (iMBCT) resulted in significant decreases in anxiety and depression. The amount of decrease in anxiety was related to the baseline depression level with the most depressed participants having the greatest reductions, while the amount of decrease in depression was related to the baseline self-compassion level with the participants with the highest levels of self-compassion having the greatest reductions. Neither mindfulness, therapy related working reliance, nor were related to the improvements.

 

These are interesting results that replicate previous findings of mindfulness training producing improvements in depression and anxiety in cancer patients, and that mindfulness training over the internet is effective in improving cancer patients. The primary intent of the research, though, was to examine predictors of patient responsiveness to the therapy. The results here were disappointing as only baseline self-compassion was related to depression improvements and only baseline depression was related to improvements in anxiety. Regardless, it is clear that mindfulness training can be successfully implemented over the internet and it is effective in improving the levels of anxiety and depression in cancer survivors.

 

So, improve psychological well-being in cancer survivors with online Mindfulness-Based Cognitive Therapy (iMBCT).

 

“I love being more mindful. Instead of waiting for the flowers to come out, I go out in the garden and see what is happening now. I am happier. Things still get difficult at times and when they do, I do my practice.” – MBCT Patient

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Nissen, E. R., Zachariae, R., O’Connor, M., Kaldo, V., Jørgensen, C. R., Højris, I., Borre, M., & Mehlsen, M. (2021). Internet-delivered Mindfulness-Based Cognitive Therapy for anxiety and depression in cancer survivors: Predictors of treatment response. Internet interventions, 23, 100365. https://doi.org/10.1016/j.invent.2021.100365

 

Abstract

Background

The present study investigates possible predictors of treatment response in an Internet-delivered Mindfulness-Based Cognitive Therapy (iMBCT) intervention with therapist support. This iMBCT program, a fully online delivered intervention with asynchronous therapist support, has previously been shown to be efficacious in reducing symptoms of anxiety and depression in women treated for breast cancer and men treated for prostate cancer.

Methods

Eighty-two breast- and prostate cancer survivors experiencing psychological distress received 8 weeks of therapist-guided iMBCT. Primary outcomes were improvement in anxiety and depression scores from baseline to post-treatment and from baseline to six-months follow-up. Clinical predictors included levels of depression and anxiety at the time of screening and at baseline, as well as time since diagnosis. Demographic predictors included age and educational level. Therapy-related predictors included working alliance, self-compassion, and five facets of mindfulness. Mixed Linear Models were employed to test the prediction effects over time.

Results

Higher levels of baseline depression were associated with increased treatment response in anxiety at post-treatment, and lower levels of self-compassion were associated with increased treatment response in depression at post-treatment. None of the proposed predictors significantly predicted treatment response at six-months follow-up.

Conclusion

The findings suggest that iMBCT can be provided for cancer survivors regardless of their age, educational level, and time since diagnosis (up to five years) and that therapeutic alliance is not crucial for treatment response. We did not identify characteristics predicting treatment response, although many factors were tested. Still, other characteristics may be predictors, and given the relatively small sample size and a large number of statistical tests, the results should be interpreted with caution.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7843453/

 

Improve the Psychological Well-Being of Breast Cancer Survivors with Mindfulness

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Improve the Psychological Well-Being of Breast Cancer Survivors with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness is a good resource for dealing with the physical and psychological symptoms of metastatic disease. Women who were more mindful tended to have lower symptoms of metastatic breast cancer, including pain severity and interference, fatigue, psychological distress, and sleep disturbance.” – Lauren Zimmaro

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. But, surviving cancer carries with it a number of problems. Anxiety, depression, fatigue and insomnia are common symptoms in the aftermath of surviving breast cancer. These symptoms markedly reduce the quality of life of the patients.

 

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including stress,  sleep disturbance, and anxiety and depression. The Mindfulness-Based Stress Reduction (MBSR) program is a mindfulness training program that includes meditation practice, body scan, yoga, and discussion along with daily home practice. MBSR has been shown to be beneficial for cancer patients in general and also specifically for the symptoms of breast cancer survivors. So, it makes sense to further explore the effectiveness of MBSR training for the treatment of breast cancer survivors.

 

In today’s Research News article “Mindfulness-Based Stress Reduction in Post-treatment Breast Cancer Patients: Immediate and Sustained Effects Across Multiple Symptom Clusters.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7771358/ ) Reich and colleagues recruited breast cancer survivors and randomly assigned them to either usual care or to receive a 6-week, once a week for 2-hours, Mindfulness-Based Stress Reduction (MBSR) modified for breast cancer survivors. They were measured before and after training and 6 weeks later for worry, fear of cancer recurrence, anxiety, depression, perceived stress, mindfulness, symptom severity, sleep quality, fatigue, pain, cognition, and health-related quality of life.

 

They found with factor analysis that the measures fit into 4 clusters; pain, cognition, fatigue, and psychological. They found that in comparison to baseline the usual care, Mindfulness-Based Stress Reduction (MBSR) produced significant improvement in the psychological and fatigue clusters, but not the cognitive or pain clusters. These effects were still present 6 weeks later.

 

These findings suggest that Mindfulness-Based Stress Reduction (MBSR) is an effective treatment to relieve the psychological and fatigue symptoms of breast cancer survivors. This corresponds with prior findings that mindfulness improves the symptoms of breast cancer survivors and reduces anxiety, depression, and perceived stress, and improves emotional well-being and also reduces fatigue and improves sleep quality.

 

The observed improvements produced by Mindfulness-Based Stress Reduction (MBSR) markedly improves the quality of life and reduces the suffering of these cancer patients. These are clinically significant. It has been shown that an improved psychological outlook is associated with better physical recovery. Hence, these findings suggest that MBSR or other mindfulness training programs, should be incorporated into the routine care of breast cancer survivors.

 

So, improve the psychological well-being of breast cancer survivors with mindfulness.

 

“Mindfulness is a state of mind which we can all acquire and use to support our wellbeing physically, emotionally and mentally. . .  Having cancer, or specifically breast cancer, is no exception. Our cancer experiences take up a lot of energies, mental focus and can drain us emotionally. It is important to have a few tools to help us create ‘down’ and ‘out’ times, and to replenish and reconnect with who we are.“ – Breast Cancer Now

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Reich, R. R., Lengacher, C. A., Alinat, C. B., Kip, K. E., Paterson, C., Ramesar, S., Han, H. S., Ismail-Khan, R., Johnson-Mallard, V., Moscoso, M., Budhrani-Shani, P., Shivers, S., Cox, C. E., Goodman, M., & Park, J. (2017). Mindfulness-Based Stress Reduction in Post-treatment Breast Cancer Patients: Immediate and Sustained Effects Across Multiple Symptom Clusters. Journal of pain and symptom management, 53(1), 85–95. https://doi.org/10.1016/j.jpainsymman.2016.08.005

 

Abstract

Context.

Breast cancer survivors (BCS) face adverse physical and psychological symptoms, often co-occurring. Biologic and psychological factors may link symptoms within clusters, distinguishable by prevalence and/or severity. Few studies have examined the effects of behavioral interventions or treatment of symptom clusters.

Objectives.

The aim of this study was to identify symptom clusters among post-treatment BCS and determine symptom cluster improvement following the Mindfulness-Based Stress Reduction for Breast Cancer (MBSR(BC)) program.

Methods.

Three hundred twenty-two Stage 0–III post-treatment BCS were randomly assigned to either a six-week MBSR(BC) program or usual care. Psychological (depression, anxiety, stress, and fear of recurrence), physical (fatigue, pain, sleep, and drowsiness), and cognitive symptoms and quality of life were assessed at baseline, six, and 12 weeks, along with demographic and clinical history data at baseline. A three-step analytic process included the error-accounting models offactor analysis and structural equation modeling.

Results.

Four symptom clusters emerged at baseline: pain, psychological, fatigue, and cognitive. From baseline to six weeks, the model demonstrated evidence of MBSR(BC) effectiveness in both the psychological (anxiety, depression, perceived stress and QOL, emotional well-being) (P = 0.007) and fatigue (fatigue, sleep, and drowsiness) (P < 0.001) clusters. Results between six and 12 weeks showed sustained effects, but further improvement was not observed.

Conclusion.

Our results provide clinical effectiveness evidence that MBSR(BC) works to improve symptom clusters, particularly for psychological and fatigue symptom clusters, with the greatest improvement occurring during the six-week program with sustained effects for several weeks after MBSR(BC) training.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7771358/

 

Movement-Based Therapies are Affective for Rehabilitation from Disease

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Movement-Based Therapies are Affective for Rehabilitation from Disease

 

By John M. de Castro, Ph.D.

 

“Tai chi is often described as “meditation in motion,” but it might well be called “medication in motion.” There is growing evidence that this mind-body practice, which originated in China as a martial art, has value in treating or preventing many health problems.” – Havard Health

 

Mindful movement practices such as yoga and Tai Chi and Qigong have been used for centuries to improve the physical and mental health and well-being of practitioners. But only recently has the effects of these practices come under scientific scrutiny. This research has been accumulating. So, it makes sense to pause and examine what has been learned about the effectiveness of these practice for rehabilitation from disease.

 

In today’s Research News article “Movement-Based Therapies in Rehabilitation.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7476461/ ) Phuphanich and colleagues review and summarize the published research studies of the effects of mindful movement practices on rehabilitation from disease.

 

They report that published research has found that yoga practice reduces fatigue, sleep disturbances, depression, and anxiety and improves the immune system in cancer patients. Yoga has been found to be an effective treatment for mental health issues such as anxiety, depression, and post-traumatic stress disorder (PTSD). Yoga has been found to reduce pain levels, fear avoidance, stress, and sleep disturbance and increases self-efficacy and quality of life in chronic pain patients. Yoga has been found to improve the symptoms of traumatic brain injury, stroke, spinal cord injury, Parkinson disease, dementia, multiple sclerosis, epilepsy, and neuropathies. In addition, yoga has been found to improve systolic and diastolic blood pressures, heart rate, respiratory rate, waist circumference, waist/hip ratio, cholesterol, triglycerides, hemoglobin A1c, and insulin resistance in cardiopulmonary diseases.

 

They report that the published research has found that Tai Chi and Qigong practices reduce falls in the elderly. Tai Chi and Qigong has been found to reduce pain levels and increase quality of life in chronic pain patients. In addition, there is evidence that Tai Chi and Qigong practices improves depression, anxiety, posttraumatic stress disorder, sleep disturbance, schizophrenia, rheumatoid arthritis, spinal cord injury, traumatic brain injury, and immune disorders.

 

These are remarkable findings. The range of disorders that are positively affected by yoga, Tai Chi, and Qigong practices is breathtaking. These practices are also safe and can be widely implemented at relatively low cost and can be performed alone or in groups and at home or in a therapeutic setting. This suggests that these practices should be routinely implemented for rehabilitation from disease.

 

So,  movement-based therapies are affective for rehabilitation from disease.

 

“Being mindful through any physical activity can not only improve performance in the activity such as yoga, tennis, swimming, etc, but it can also increase flexibility, confidence in movement and generate a sense of body and mind connection that has the potential for improving your overall sense of well-being.“- Anupama Kommu

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Phuphanich, M. E., Droessler, J., Altman, L., & Eapen, B. C. (2020). Movement-Based Therapies in Rehabilitation. Physical medicine and rehabilitation clinics of North America, 31(4), 577–591. https://doi.org/10.1016/j.pmr.2020.07.002

 

Abstract

Movement therapy refers to a broad range of Eastern and Western mindful movement-based practices used to treat the mind, body, and spirit concurrently. Forms of movement practice are universal across human culture and exist in ancient history. Research demonstrates forms of movement therapy, such as dance, existed in the common ancestor shared by humans and chimpanzees, approximately 6 million years ago. Movement-based therapies innately promote health and wellness by encouraging proactive participation in one’s own health, creating community support and accountability, and so building a foundation for successful, permanent, positive change.

Key Points – Movement-based therapies

  • Decrease fear avoidance and empower individuals to take a proactive role in their own health and wellness.
  • Can benefit patients of any ability; practices are customizable to the individual’s needs and health.
  • Are safe, cost-effective, and potent adjunct treatments used to supplement (not replace) standard care.
  • Deliver patient-centered, integrative care that accounts for the physical, psychological, social, and spiritual aspects of health and illness.
  • Have diverse, evidence-based benefits, including reduction in pain, stress, and debility, and improvements in range of motion, strength, balance, coordination, cardiovascular health, physical fitness, mood, and cognition.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7476461/

 

Spirituality is Associated with Reduced Emotional Distress in Lung Cancer Survivors

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Spirituality is Associated with Reduced Emotional Distress in Lung Cancer Survivors

 

By John M. de Castro, Ph.D.

 

“However you define spirituality, studies show that it can play an important role in coping with the recovery and healing process from cancer treatment and its after effects.” – LungCancer.org

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. These feeling can result from changes in body image, changes to family and work roles, feelings of grief at these losses, and physical symptoms such as pain, nausea, or fatigue. People might also fear death, suffering, pain, or all the unknown things that lie ahead. So, coping with the emotional distress and stress of a cancer diagnosis is a challenge and there are no simple treatments for these psychological sequelae of cancer diagnosis.

 

Religion and spirituality become much more important to people when they’re diagnosed with cancer or when living with cancer. It is thought that people take comfort in the spiritual when facing mortality. Hence, spirituality may be a useful tool for the survivors of cancer to cope with their illness and the consequent emotional distress. Thus, it makes sense to study the relationships of spirituality with the mental health of cancer survivors.

 

In today’s Research News article “Spirituality and Emotional Distress Among Lung Cancer Survivors.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6859202/ ) Gudenkauf and colleagues recruited adult patients with lung cancer and had them complete questionnaires measuring spirituality, emotional distress, and quality of life. within 1 year of their diagnosis and 1 year later.

 

They found that the lung cancer survivors, not surprisingly, were generally high in emotional distress. But those survivors who were high in spirituality, including the meaning, peace, and faith dimensions, were high in quality of life and low in emotional distress. In addition, those survivors who were high in distress at the first measurement, if they were also high in spirituality meaning, were more likely to have low emotional distress 1 year later.

 

It should be kept in mind that the present study was observational and as a result causation cannot be determined. But it appears that in these lung cancer survivors, spirituality is associated with better quality of life and lower emotional distress and that spirituality tends to predict lower emotional distress a year later. Hence, spirituality appears to help survivors cope with their emotional reactions to their diagnosis. Future studies should investigate whether promoting spirituality in these survivors may improve their emotions and quality of life.

 

So, spirituality is associated with reduced emotional distress in lung cancer survivors.

 

“While having a spiritual or religious foundation can’t change your diagnosis or the effectiveness of treatment, some patients find their beliefs help them find meaning and cope. “It may not impact your prognosis, but it can help improve your overall outlook during treatment,” – Tiffany Meyer

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Gudenkauf, L. M., Clark, M. M., Novotny, P. J., Piderman, K. M., Ehlers, S. L., Patten, C. A., Nes, L. S., Ruddy, K. J., Sloan, J. A., & Yang, P. (2019). Spirituality and Emotional Distress Among Lung Cancer Survivors. Clinical lung cancer, 20(6), e661–e666. https://doi.org/10.1016/j.cllc.2019.06.015

 

Abstract

Background:

Emerging research is highlighting the importance of spirituality in cancer survivorship as well as the importance of early distress screening. The purpose of this study was to prospectively examine the relationships among spirituality, emotional distress, and sociodemographic variables during the early period of lung cancer survivorship.

Patients and Methods:

864 lung cancer survivors completed the Functional Assessment of Chronic Illness Therapy – Spiritual Well-Being (FACIT-Sp), and the Short-Form-8 (SF-8) for emotional distress within the first year following lung cancer diagnosis, and 474 of these survivors completed the survey again one year later.

Results:

At baseline, spirituality was associated with lower prevalence of emotional distress, being married, fewer years of cigarette smoking, and better ECOG performance status. Additionally, high baseline spirituality was associated with lower rates of high emotional distress at one-year follow-up.

Conclusion:

These findings suggest that spirituality may serve as a protective factor for emotional distress among lung cancer survivors. Further research is warranted to explore the role of spirituality in promoting distress management among lung cancer survivors.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6859202/

 

Cancer Patients’ Quality of Life is Associated with Mindfulness

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Cancer Patients’ Quality of Life is Associated with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness-based intervention . . . may help to decrease the stress of cancer-related cognitive impairment and can therefore indirectly improve quality of life in this patient population.” – Hannah Slater

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. But, surviving cancer carries with it a number of problems. Anxiety, depression, fatigue and insomnia are common symptoms in the aftermath of surviving breast cancer. These symptoms markedly reduce the quality of life of the patients. Mindfulness training has been shown to help with cancer recovery and help to relieve chronic pain. It can also help treat the residual physical and psychological symptoms, including stress, sleep disturbance, fear, and anxiety and depression.

 

In today’s Research News article “Stress and Quality of Life of Patients with Cancer: The Mediating Role of Mindfulness.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7748895/ ) Dehghan and colleagues recruited adult patients diagnosed with cancer and had them complete measures of mindfulness, perceived stress, and quality-of-life; including overall, functioning, and symptoms. They performed regression and path analysis on these data.

 

They found that the higher the level of mindfulness, the higher the level of quality-of-life functioning and the lower the level of perceived stress and quality of life symptoms. Also, the higher the level of perceived stress the higher the level of quality-of-life symptoms and the lower the level of overall and functioning quality of life. They reported from the path analysis that perceived stress was associated with poorer quality of life directly and indirectly by being associated with lower levels of mindfulness which were in turn associated with greater quality of life. In other words, perceived stress was associated with reduced quality of life in part by being associated with reduced mindfulness.

 

These results are correlative and causation cannot be determined. But prior manipulative research has demonstrated that mindfulness produces lower perceived stress and greater quality of life, So, the associations reported here are likely due to causal connections between the variables. Hence, the findings suggest that the quality of life of cancer patients is lowered by stress and this is in part due to stress lowering mindfulness.

 

So, cancer patients’ quality of life is associated with mindfulness.

 

“Mindfulness based interventions hold a great deal of promise for helping people with cancer cope across a broad range of symptoms and issues, both during and after the completion of active treatment.” – Jessica Pieczynski

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Dehghan, M., Jazinizade, M., Malakoutikhah, A., Madadimahani, A., Iranmanesh, M. H., Oghabian, S., Mohammadshahi, F., Janfaza, F., & Zakeri, M. A. (2020). Stress and Quality of Life of Patients with Cancer: The Mediating Role of Mindfulness. Journal of Oncology, 2020, 3289521. https://doi.org/10.1155/2020/3289521

 

Abstract

Background

Cancer is one of the major health problems worldwide, which in addition to physical disorders, causes stress and anxiety in patients and affects the quality of life of cancer patients. Mindfulness can affect stress and improve the quality of life. This research explained the correlation between stress, quality of life, and mindfulness.

Materials and Methods

Two hundred five cancer patients participated in this cross-sectional study. Patients completed the EORTC Quality of Life Questionnaire Core 30 (EORTC QLQ-C30), the Mindfulness Attention and Awareness Scale (MAAS), and Perceived Stress Scale (PSS).

Results

Perceived stress and mindfulness predict nearly 39% of the changes of QOL in cancer patients. In addition, perceived stress was negatively associated with mindfulness and quality of life (P < 0.05). Mindfulness was positively correlated with quality of life (P < 0.05). Mindfulness played a mediating role in the relationship between perceived stress and quality of life (standardized β = −0.13; SE = 0.07, 95% confidence interval = −0.28 to −0.01; P value = 0.04).

Conclusion

In the present study, the variables of mindfulness and perceived stress affected the quality of life of cancer patients. Mindfulness can affect the quality of life of cancer patients directly and indirectly. These results emphasize the importance of mindfulness in the lives of cancer patients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7748895/

 

Improve the Psychological Health of Cancer Patients with Mindfulness Taught over the Internet

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Improve the Psychological Health of Cancer Patients with Mindfulness Taught over the Internet

 

By John M. de Castro, Ph.D.

 

“some of the most difficult elements of the cancer experience are very well-suited to a mindfulness practice.” – Linda Carlson

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. But, surviving cancer carries with it a number of problems. Anxiety, depression, fatigue and insomnia are common symptoms in the aftermath of surviving cancer. These symptoms markedly reduce the quality of life of the patients.

 

Mindfulness training has been shown to help with cancer recovery and help to relieve chronic pain. It can also help treat the residual physical and psychological symptoms, including stress,  sleep disturbance, fear, and anxiety and depression. The vast majority of the mindfulness training techniques, however, require a trained therapist. This results in costs that many clients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules and at locations that may not be convenient.

 

As an alternative, mindfulness training over the internet have been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. In addition, research has indicated that mindfulness training online can be effective for improving the health and well-being of the participants. The research has been accumulating. So, it makes sense to step back and summarize what has been learned about the effectiveness of mindfulness training over the internet in treating the psychological symptoms of cancer patients.

 

In today’s Research News article “Mindfulness-Based Programs for Patients With Cancer via eHealth and Mobile Health: Systematic Review and Synthesis of Quantitative Research.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7704284/ ) Matis and colleagues review, summarize, and perform a meta-analysis on the published research studies on the effectiveness of mindfulness training over the internet in treating the psychological symptoms of cancer patients. They identified 24 published research studies including at least 4 weeks of mindfulness training delivered over the internet.

 

They report that the published research studies found that mindfulness training delivered over the internet to cancer patients produced significant decreases in stress, anxiety, depression, pain, fatigue, and sleep problems, and significant increases in mindfulness, posttraumatic growth, and some parameters of general health. In the few studies where long-term follow-up measures were obtained the effects were maintained.

 

These are very promising results that suggest that mindfulness training over the internet is a safe and effective treatment for the psychological issues common in cancer survivors. Mindfulness training, in general, has been shown in a large number of previous studies o be effective in reducing stress, anxiety, depression, pain, fatigue, and sleep problems, and significant increases in mindfulness, posttraumatic growth, and some parameters of general health. So, the present study simply extends these findings to patients with cancer who receive mindfulness training over the internet.

 

These results are important as good mental health, particularly the ability to cope with stress, are predictors of good health outcomes. In addition, the fact that the interventions were provided over the internet allows for cost-effective and convenient delivery to patients. This makes participation and compliance more likely and effective. Hence, internet-based mindfulness training may help relieve the psychological suffering of patients diagnosed with cancer and should be included in their treatment plan.

 

So, improve the psychological health of cancer patients with mindfulness taught over the internet.

 

“Both MBCT and eMBCT significantly reduced fear of cancer recurrence and rumination and increased mental health–related quality of life, mindfulness skills, and positive mental health.” – Matthew Stenger

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Matis, J., Svetlak, M., Slezackova, A., Svoboda, M., & Šumec, R. (2020). Mindfulness-Based Programs for Patients With Cancer via eHealth and Mobile Health: Systematic Review and Synthesis of Quantitative Research. Journal of medical Internet research, 22(11), e20709. https://doi.org/10.2196/20709

 

Abstract

Background

eHealth mindfulness-based programs (eMBPs) are on the rise in complex oncology and palliative care. However, we are still at the beginning of answering the questions of how effective eMBPs are and for whom, and what kinds of delivery modes are the most efficient.

Objective

This systematic review aims to examine the feasibility and efficacy of eMBPs in improving the mental health and well-being of patients with cancer, to describe intervention characteristics and delivery modes of these programs, and to summarize the results of the included studies in terms of moderators, mediators, and predictors of efficacy, adherence, and attrition.

Methods

In total, 4 databases (PubMed, PsycINFO, Scopus, and Web of Knowledge) were searched using relevant search terms (eg, mindfulness, program, eHealth, neoplasm) and their variations. No restrictions were imposed on language or publication type. The results of the efficacy of eMBPs were synthesized through the summarizing effect estimates method.

Results

A total of 29 published papers describing 24 original studies were included in this review. In general, the results indicate that eMBPs have the potential to reduce the levels of stress, anxiety, depression, fatigue, sleep problems, and pain, and improve the levels of mindfulness, posttraumatic growth, and some parameters of general health. The largest median of Cohen d effect sizes were observed in reducing anxiety and depression (within-subject: median −0.38, IQR −0.62 to −0.27; between-group: median −0.42, IQR −0.58 to −0.22) and facilitating posttraumatic growth (within-subject: median 0.42, IQR 0.35 to 0.48; between-group: median 0.32, IQR 0.22 to 0.39). The efficacy of eMBP may be comparable with that of parallel, face-to-face MBPs in some cases. All studies that evaluated the feasibility of eMBPs reported that they are feasible for patients with cancer. Potential moderators, mediators, and predictors of the efficacy, attrition, and adherence of eMBPs are discussed.

Conclusions

Although the effects of the reviewed studies were highly heterogeneous, the review provides evidence that eMBPs are an appropriate way for mindfulness practice to be delivered to patients with cancer. Thus far, existing eMBPs have mostly attempted to convert proven face-to-face mindfulness programs to the eHealth mode. They have not yet fully exploited the potential of eHealth technology.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7704284/