The Effect of 5 Minutes of Mindful Breathing to the Perception of Distress and Physiological Responses in Palliative Care Cancer Patients: A Randomized Controlled Study
Abstract:Five-minute MB is a quick, easy to administer, and effective therapy for rapid reduction of distress in palliative setting. There is a need for future study to establish the long-term efficacy of the therapy.
“…The other outcomes analysed by this study were: quality of life ‐ subscore activity (SGRQ) (MD 2.20, 95% CI −6.07 to 10.47; P = .60; participants 49); quality of life – symptom subscore (SGRQ) (MD 5.20, 95%CI −5.27 to 15.67; P = .33; participants: 49); quality of life – subscore impact (SGRQ) (MD 4.30, 95%CI −2.80 to 11.40; P = .23; participants: 49); perceived distress (Perceived Stress Scale) (MD −0.20, 95%CI −3.66 to 3.26; P = .91; participants: 49); quality of life – mental aspects (MD 4.10, 95%CI −3.25 to 11.45; P = .27; participants: 49); 6‐minute walk test (6MWT) (MD −24.10, 95%CI −84.06 to 35.86; P = .43; participants: 49); dyspnoea severity (post‐6MWT Modified Borg Dyspnoea Level) (MD −0.30, 95%CI −1.64 to 1.04; P = .66; participants: 49); symptom experience (MSAS) (MD 0.29, 95%CI −0.05 to 0.63; P = .09; participants: 49); self conscience (5‐Factor Mindfulness Questionnaire) (MD −0.70, 95%CI −9.23 to 7.83; P = .87; participants: 49); dyspnoea at rest (EVA) (MD −1.50, 95%CI −14.16 to 11.16; P = .82; participants: 49); dyspnoea at activity (EVA) (MD 1.40, 95%CI −10.36 to 13.16; P = .82; participants: 49); worsening of dyspnoea symptoms (diary) (MD −0.15, 95%CI −0.78 to 0.48; P = .64; participants: 44). Comparison: Mindfulness X control; outcome: quality of life physical aspects.Mindfulness in single 5‐minute session vs control (5 standard questions in 5 minutes) . For the outcome stress, evaluated by the Distress Thermometer, there was statistically significant differences in both time‐points of evaluation (immediately after intervention and after 10 minutes) (MD −1.80, 95%CI −1.99 to −0.17; P = .02 (immediately after intervention); and MD −1.05, 95%CI −1.94 to −0.16; P = .02 (after 10 minutes); participants: 60) in favour of the mindfulness meditation, although we cannot claim that this reflects a relevant clinical difference.…”
Section: Resultsmentioning
confidence: 99%
“…The initial search retrieved 15 126 records. After the two‐stage screening process, we included 5 RCTs: 4 finalised studies, and 1 ongoing study . The detailed selection process is depicted in Figure .…”
Section: Resultsmentioning
confidence: 99%
“…The disparity of mindfulness techniques reflects the lack of standardisation and significant variations from the traditional technique developed by Jon Kabat‐Zinn . Two studies presented schemes of mindfulness similar to the one developed by Jon Kabat‐Zinn and two studies evaluated a single session involving patient and facilitator …”
Although two studies have showed statistically significant difference, only one showed effectiveness of mindfulness meditation in improving perceived stress. This study focused on one single session of mindfulness of 5 minutes for adult cancer patients in palliative care, but it was considered as possessing high risk of bias. Other schemes of mindfulness meditation did not show benefit in any outcome evaluated (low and very low quality evidence).
“…The other outcomes analysed by this study were: quality of life ‐ subscore activity (SGRQ) (MD 2.20, 95% CI −6.07 to 10.47; P = .60; participants 49); quality of life – symptom subscore (SGRQ) (MD 5.20, 95%CI −5.27 to 15.67; P = .33; participants: 49); quality of life – subscore impact (SGRQ) (MD 4.30, 95%CI −2.80 to 11.40; P = .23; participants: 49); perceived distress (Perceived Stress Scale) (MD −0.20, 95%CI −3.66 to 3.26; P = .91; participants: 49); quality of life – mental aspects (MD 4.10, 95%CI −3.25 to 11.45; P = .27; participants: 49); 6‐minute walk test (6MWT) (MD −24.10, 95%CI −84.06 to 35.86; P = .43; participants: 49); dyspnoea severity (post‐6MWT Modified Borg Dyspnoea Level) (MD −0.30, 95%CI −1.64 to 1.04; P = .66; participants: 49); symptom experience (MSAS) (MD 0.29, 95%CI −0.05 to 0.63; P = .09; participants: 49); self conscience (5‐Factor Mindfulness Questionnaire) (MD −0.70, 95%CI −9.23 to 7.83; P = .87; participants: 49); dyspnoea at rest (EVA) (MD −1.50, 95%CI −14.16 to 11.16; P = .82; participants: 49); dyspnoea at activity (EVA) (MD 1.40, 95%CI −10.36 to 13.16; P = .82; participants: 49); worsening of dyspnoea symptoms (diary) (MD −0.15, 95%CI −0.78 to 0.48; P = .64; participants: 44). Comparison: Mindfulness X control; outcome: quality of life physical aspects.Mindfulness in single 5‐minute session vs control (5 standard questions in 5 minutes) . For the outcome stress, evaluated by the Distress Thermometer, there was statistically significant differences in both time‐points of evaluation (immediately after intervention and after 10 minutes) (MD −1.80, 95%CI −1.99 to −0.17; P = .02 (immediately after intervention); and MD −1.05, 95%CI −1.94 to −0.16; P = .02 (after 10 minutes); participants: 60) in favour of the mindfulness meditation, although we cannot claim that this reflects a relevant clinical difference.…”
Section: Resultsmentioning
confidence: 99%
“…The initial search retrieved 15 126 records. After the two‐stage screening process, we included 5 RCTs: 4 finalised studies, and 1 ongoing study . The detailed selection process is depicted in Figure .…”
Section: Resultsmentioning
confidence: 99%
“…The disparity of mindfulness techniques reflects the lack of standardisation and significant variations from the traditional technique developed by Jon Kabat‐Zinn . Two studies presented schemes of mindfulness similar to the one developed by Jon Kabat‐Zinn and two studies evaluated a single session involving patient and facilitator …”
Although two studies have showed statistically significant difference, only one showed effectiveness of mindfulness meditation in improving perceived stress. This study focused on one single session of mindfulness of 5 minutes for adult cancer patients in palliative care, but it was considered as possessing high risk of bias. Other schemes of mindfulness meditation did not show benefit in any outcome evaluated (low and very low quality evidence).
“…Prior to mindfulness meditation, participants are instructed to focus on breathing and to let their minds wander, not to focus attention on worries or negative thoughts [51]. Previous studies demonstrated that mindfulness breathing technique used alone alleviated subjective distress and improved meta-cognitive function, emotional non-reactivity, and autonomic nervous control in healthy individuals and those with physical ailments [51][52][53]. According to Ng et al [53], 5 minutes of brief mindfulness breathing technique lessened subjective distress, and improved blood pressure, pulse rate, and breathing rate in subjects in palliative care cancer patients.…”
Section: Breathing Technique Of Mindfulness Meditationmentioning
confidence: 99%
“…Previous studies demonstrated that mindfulness breathing technique used alone alleviated subjective distress and improved meta-cognitive function, emotional non-reactivity, and autonomic nervous control in healthy individuals and those with physical ailments [51][52][53]. According to Ng et al [53], 5 minutes of brief mindfulness breathing technique lessened subjective distress, and improved blood pressure, pulse rate, and breathing rate in subjects in palliative care cancer patients. Furthermore, Arch and Craske [51] indicated that 15 minutes of mindfulness breathing enhances an individual's emotional non-reactivity during presentation of negative pictures.…”
Section: Breathing Technique Of Mindfulness Meditationmentioning
Body-mind approaches (e.g., yoga, mindfulness meditation, Pilates method, and cognitive behavior therapy) are commonly used by the public today. However, the comprehensive neurobiological framework of effects of body-mind approaches is unknown. To begin, we discuss the dynamic and static models of each body-mind approaches from neurobiological perspectives, as well as from the standpoint of practical issues. By the dynamic components of body-mind approaches, people enhances meta-cognitive function, and it lead to decreases in avoidance behavior in social aversive context are suggested. On the other hand, it is assumed that static components of body-mind approaches enhance non-reactive monitoring function for baseline of self. Therefore, we discuss the implications of these findings for practitioners and for future research on body-mind researchers. Additionally, this chapter covers the essential ethical guidelines of body-mind approaches within the domain of medical or educational fields.
Optimal sequencing of complementary therapies can help improve symptom management through nonpharmacological approaches. A 12‐week sequential multiple assignment randomized trial comparing home‐based reflexology and meditative practices on severity of fatigue and other symptoms was conducted among patients with cancer and their informal caregivers. Dyads were initially randomized to reflexology (N = 150), meditative practices (N = 150), or control (N = 47). If patient's fatigue did not improve (nonresponse) after 4 weeks of reflexology or meditative practices, the dyad was rerandomized to either add the other therapy or continue with the original therapy for weeks 5–8. Four decision rules (DRs) were compared: (1) Initiating reflexology, and if nonresponse on fatigue after 4 weeks, continue with reflexology for another 4 weeks, thus providing a higher dose; (2) Initiating reflexology, and if nonresponse on fatigue after 4 weeks, add meditative practices for the next 4 weeks; (3) Initiating meditative practices, and if nonresponse on fatigue after 4 weeks, continue meditative practices for another 4 weeks, thus providing a higher dose; and (4) Initiating meditative practices, and if nonresponse on fatigue after 4 weeks, add reflexology for the next 4 weeks. Symptoms were evaluated weekly using the M.D. Anderson Symptom Inventory (MDASI). Clinically, nurses can recommend either therapy since no differences were found among the 4 DRs, with the exception of lower severity for summed MDASI symptoms at week 8 for the use of reflexology only (DR‐1) versus DR‐2 (sequencing reflexology to meditative practices). Adding the other therapy for nonresponders after 4 weeks may not be warranted.
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