iPad-assisted meditation during chemotherapy infusion

Millegan, J., Manschot, B., Dispenzieri, M., Marks, B., Edwards, A., Raulston, V., … & Narro, M. (2015). Leveraging iPads to introduce meditation and reduce distress among cancer patients undergoing chemotherapy: a promising approach. Supportive Care in Cancer, 1-2. Abstract only.

Distress is common among cancer patients. Regular meditation practice has the potential to mitigate this distress and improve quality of life for this population. Introducing meditation to cancer patients can be particularly challenging given the demands on patients’ time from treatment and normal life events. This internal process improvement study examined the potential benefit of utilizing iPads during chemotherapy sessions to introduce meditation and reduce distress.

Patients undergoing chemotherapy infusion were offered iPads with various meditation videos and audio files during the session. Levels of distress were measured using the distress thermometer at the beginning of chemotherapy and at the conclusion of chemotherapy.

Seventy-three patients accepted the meditation iPads during the chemotherapy session. Among those who accepted the iPads, average distress dropped 46 % by the end of the session.

Efficacy of meditation on stress-related outcomes (review)

Goyal, M., et al.  (2014). Meditation Programs for Psychological Stress and Well-Being. Comparative Effectiveness Reviews, No. 124. Full text.

Objective: Meditation, a mind-body method, employs a variety of techniques designed to facilitate the mind’s capacity to affect bodily function and symptoms. An increasing number of patients are using meditation programs despite uncertainty about the evidence supporting the health benefits of meditation. We aimed to determine the efficacy and safety of meditation programs on stress-related outcomes (e.g., anxiety, depression, stress, distress, well-being, positive mood, quality of life, attention, health-related behaviors affected by stress, pain, and weight) compared with an active control in diverse adult clinical populations.

Conclusions: Meditation programs, in particular mindfulness programs, reduce multiple negative dimensions of psychological stress. Stronger study designs are needed to determine the effects of meditation programs in improving the positive dimensions of mental health as well as stress-related behavioral outcomes.

Single-session meditation in oncology outpatient clinic

Chaoul, A., et al. (2014). An Analysis of Meditation Consultations in an Integrative Oncology Outpatient Clinic. The Journal of Alternative and Complementary Medicine, 20(5), A86-A86.

From the Abstract. The majority of cancer patients use some complementary medicine modality. Mind-body practices, and especially meditation, are amongst the most utilized. Research shows that they help cancer patients manage psychological distress and control symptoms such as pain, nausea, and sleep disturbances. However, the effects of a single meditation session on self-reported symptoms, including physical, psychological and symptom distress in an outpatient setting, are largely unknown.

All patients [received] an individual meditation consultation (60 minute initial visits, and 30 minute follow-up visits). Our analysis included 81 meditation visits for 121 participants over 32 months. The [results] revealed a significant reduction from pre- to post-meditation session in physical, psychological, and symptom distress component scores. The greatest mean reductions for individual symptoms were for: Anxiety, Fatigue, Distress, Well Being, Sleep, and Pain; all changes reaching statistically and clinically significant thresholds.

Further research with a larger sample size is needed to better understand the symptoms that meditation can help control and the frequency of self-practice outside of the clinic to help maintain the long-term benefits.

MBCR vs. group therapy with survivors of breast cancer

Carlson, L. E., et al. (2013). Randomized controlled trial of mindfulness-based cancer recovery versus supportive expressive group therapy for distressed survivors of breast cancer (MINDSET). Journal of Clinical Oncology, 31(25), 3119-3126. From the Abstract:

Purpose. To compare the efficacy of the following two empirically supported group interventions to help distressed survivors of breast cancer cope: mindfulness-based cancer recovery (MBCR) and supportive-expressive group therapy (SET).

Patients and Methods. This multisite, randomized controlled trial assigned 271 distressed survivors of stage I to III breast cancer to MBCR, SET, or a 1-day stress management control condition. MBCR focused on training in mindfulness meditation and gentle yoga, whereas SET focused on emotional expression and group support. Both intervention groups included 18 hours of professional contact. Measures were collected at baseline and after intervention by assessors blind to study condition. Primary outcome measures were mood and diurnal salivary cortisol slopes. Secondary outcomes were stress symptoms, quality of life, and social support.

Results. Women in MBCR improved more over time on stress symptoms compared with women in both the SET and control groups. Per-protocol analyses showed greater improvements in the MBCR group in quality of life compared with control group and in social support compared with the SET group.

Conclusion. In the largest trial to date, MBCR was superior for improving a range of psychological outcomes for distressed survivors of breast cancer. Both SET and MBCR also resulted in more normative diurnal cortisol profiles than the control condition. The clinical implications of this finding require further investigation.

Effective in reducing psychological distress and improving quality of life in cancer patients

Fish, J. A., Ettridge, K., Sharplin, G. R., Hancock, B., & Knott, V. E. (2013). Mindfulness‐based Cancer Stress Management: impact of a mindfulness‐based programme on psychological distress and quality of life. European journal of cancer care. Epub ahead of print.

From the Abstract: Within the area of cancer care, mindfulness-based therapeutic interventions have been found to be efficacious in reducing psychological distress related to a cancer diagnosis; however, the impact of mindfulness-based interventions on quality of life is unclear. This study explores the impact of a Mindfulness-Based Cancer Stress Management programme on psychological distress and quality of life.

Significant improvements were observed on all measures following the intervention, which were maintained at 3-month follow-up. Mindfulness was significantly correlated with all main outcome measures at post-intervention and 3-month follow-up, providing evidence for the internal validity of the study. Our findings indicate that the MBCSM programme is effective in reducing psychological distress and improving quality of life, including spiritual well-being.

Mind, body, and spirit self-empowerment for women with breast cancer

Kinney, C. K., Rodgers, D. M., Nash, K. A., & Bray, C. O. (2003). Holistic healing for women with breast cancer through a mind, body, and spirit self-empowerment program. Journal of Holistic Nursing, 21(3), 260-279. Full text.

This article reports results of an integrated mind-body-spirit self-empowerment program for breast cancer survivors. Fifty-women at various stages of breast cancer completed a series of eclectic lessons offered in a support group format. The followed an integrated and cumulative lesson plan that progressively and systematically introduced multiple strategies creating a balance among mental, emotional, spiritual, and physical health.

The program’s goals were to enable to experience a reduction in distress, improve perceived quality of life, reach a deeper sense of meaning and purpose in life and experience a greater sense of perceived wellness. Self-assessments were obtained on four well-documented measures to both pre- and postprogram participation. Differences in pre- and postscores showed statistically significant and large estimated effect sizes on all four measures. Participants’ written comments provide examples of the scope and of the program.

Reduces ruminative thoughts and behaviors

Jain, S., et al. (2007). A randomized controlled trial of mindfulness meditation versus relaxation training: Effects on distress, positive states of mind, rumination, and distraction. Annals of Behavioral Medicine, 33(1), 11-21. Full text.

From the Abstract: Although mindfulness meditation interventions have recently shown benefits for reducing stress in various populations, little is known about their relative efficacy compared with relaxation interventions.

This randomized controlled trial examines the effects of a 1-month mindfulness meditation versus somatic relaxation training as compared to a control group in 83 students (M age=25; 16 men and 67 women) reporting distress.

The data suggest that compared with a no-treatment control, brief training in mindfulness meditation or somatic relaxation reduces distress and improves positive mood states. However, mindfulness meditation may be specific in its ability to reduce distractive and ruminative thoughts and behaviors, and this ability may provide a unique mechanism by which mindfulness meditation reduces distress.