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

  • The sample was composed of 27 participants with metastatic breast or prostate cancer.
  • Mean age of women was 60.8 years; mean age of men was 72.4 years.
  • Of female participants, 13 were in the analysis phase; of males, 14 were in the analysis phase.
  • 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

  • Single site
  • Outpatient
  • Cambridge, Cambridgeshire, England

Phase of Care and Clinical Applications

Active treatment and transition

Study Design

Randomized controlled trial

Measurement Instruments/Methods

  • World Health Organization Quality of Life Instrument-BREF (WHOQOL-BREF)
  • Hospital Anxiety and Depression Scale (HADS)
  • Social and Occupational Functioning Assessment Scale (SOFAS)
  • Life Orientation Test, Revised (LOT-R)
  • 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

  • The study had a small sample size, with fewer than 30 participants and a high attrition rate.
  • The study had risk of bias due to no blinding.
  • Measures of internal consistency reliability for the instruments were not reported.
  • Follow-up occurred by different methods: in the clinic, at home, via telephone, or by means of a mailed survey.
  • 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.