Effects of embedded micro-mindfulness on psychological symptoms in patients with advanced cancer receiving palliative care: a prospective controlled study
Abstract
Objective To evaluate changes in psychological distress, anxiety and depressive symptoms, sleep problems, and pain intensity associated with participation in an embedded micro-mindfulness program among patients with advanced cancer receiving palliative care, and to explore factors associated with psychological symptom response. Methods This single-center, prospective, non-randomized observational study included 243 patients with advanced cancer receiving palliative care at West China Hospital. Patients who participated in the departmental micro-mindfulness program in addition to usual care comprised the MM group (n = 121), whereas those who received usual care without participating in the program comprised the UC group (n = 122). Outcomes were assessed at baseline and weekly for 4 weeks. Primary outcomes were anxiety and depressive symptoms assessed using the GAD-7 and PHQ-9, respectively. Secondary outcomes included psychological distress assessed using the Distress Thermometer (DT), sleep problems assessed using the two-item Insomnia Severity Index (ISI-2), and pain intensity assessed using the Numeric Rating Scale (NRS). Results Baseline characteristics were comparable between groups. Significant group × time interactions were observed for GAD-7 (P = 0.001), PHQ-9 (P = 0.002), DT (P < 0.001), and ISI-2 (P < 0.001), with greater reductions over time observed in the MM group. The group × time interaction for NRS was not significant (P = 0.371). In the MM group, 73 patients (60.3%) achieved psychological symptom response. Conclusion Embedded micro-mindfulness was associated with greater improvements in anxiety, depressive symptoms, psychological distress, and sleep problems, but not pain intensity. These findings support further evaluation of this brief program as a supportive-care strategy for patients with advanced cancer receiving palliative care.