Ando, M., Morita, T., Akechi, T., Ito, S., Tanaka, M., Ifuku, Y., & Nakayama, T. (2009). The efficacy of mindfulness-based meditation therapy on anxiety, depression, and spirituality in Japanese patients with cancer. Journal of Palliative Medicine, 12, 1091–1094.

To assess the efficacy of mindfulness-based meditation therapy on the anxiety, depression, and spiritual well-being of Japanese patients undergoing anticancer treatment

Researchers used a modified version of the Mindfulness-Based Stress Reduction (MBSR) Program. The modification focused on cyclic mediation (breathing and meditation). Each session lasted 30–60 minutes and was conducted by nurses or a clinical psychologist. The first session consisted of the cyclic mediation program and recommendations to perform the mediation at home once daily, using a CD or DVD. After two weeks the patients met with interviewers and discussed impressions.

• N = 28.
• Females: 24; males: 4.
• Mean patient age was 60 years (SD = 9.2 years).
• Patients' performance status was 0–2, and all patients were able to visit the hospital.
• Primary tumor sites: breast (21), colon (2), stomach (2), bladder (2).

• Single site
• Outpatient
• Japan

Pre- and postintervention questionnaire

• Hospital Anxiety and Depression Scale (HADS), Japanese version
• Functional Assessment of Chronic Illness Therapy—Spiritual (FACIT-Sp), to measure sense of meaning
• Caregiving Consequences Inventory modified to eight items, to measure psychological appreciation
• Benefit-finding scale, to measure pain, constipation, nausea, fatigue, and sleep disturbance by using three items per symptom and ratings on a 0–10 numeric scale

• HADS anxiety score decreased from 6.9 ±3.6 to 5.1 ±3.9 (p = 0.01).
• HADS depression score decreased from 5.1 ±2.9 to 3.5 ±3.1 (p = 0.009).
• Total HADS score decreased from 12 ±5.3 to 8.6 ±6.3 (p = 0.004) after the intervention.
• FACIT-Sp scores increased from 32 ±6.5 to 33 ±6.9 (p = 0.69), a change that was not significant.
• Researchers noted relationships between FACIT-Sp and HADS (r = –0.78, p = 000), FACIT-Sp and growth (r = –0.35, p = 0.04), FACIT-Sp and pain (r = –0.41, p = 0.02), and growth and appreciation (r = 0.45, p = 0.009).

The mindfulness-based intervention as provided in this study was associated with decreased anxiety and depression.

• The study had a small sample size, with fewer than 30 participants.
• The study had no control group and used convenient sampling.
• Study results were not generalizable.
• Methods were not well described.
• Researchers modified the measurement tools, using only some tool items. The researchers presented no information about the validity or reliability that resulted from these modifications.

Nursing interventions that can help reduce the anxiety and depression of cancer treatments need exploration. More studies that result in reproducible measures are needed.