Meditation as a doula-delivered intervention for underserved late-stage cancer patients: A feasibility trial.

Abstract

188 Background: Socioeconomic disparities in psychosocial outcomes among cancer patients have been documented. High interest in peer support and mind-body therapies across diverse populations presents an opportunity for enhancing end-of-life care in the underserved setting. We present the results of a psychosocial needs assessment, and the findings from a feasibility trial in which peer navigators (PN; cancer survivor volunteers) were taught to deliver Loving Kindness (LK) Meditation in preparation for their role as end-of-life “Doulas”. Methods: (1) A survey of psychosocial symptoms and needs was administered to a convenience sample of 56 stage IV patients from an NCI-designated cancer center in Bronx, NY. Patients were female (75%), African American (43%), Hispanic (45%), and 56 M years old. (2) A feasibility trial randomly assigned 9 patients to receive LK meditation delivered by 1 of 4 trained PNs or a professional meditation instructor. The trial was rated on 8 measures of feasibility as set forth by Bowen et al 2009. Results: Patients reported high sadness (66%), anxiety (54%), anger (41%), and spiritual distress (18%) with 70% endorsing an interest in mind-body therapies “such as meditation”, and 46% an interest in a PN. In the LK meditation feasibility trial, patients reported improved positive affect scores by a clinically significant margin of 13%, with equivalent impact and satisfaction for PN relative to professional instructor. Conclusions: Inner city late stage cancer patients endorse high distress, and high interest in peer support and mind-body interventions. Feasibility testing demonstrates that LK meditation is responsive to patient preference and demonstrates preliminary efficaciousness. Findings suggest that Doula-delivered meditation for underserved patients presents a unique resource in the palliative care setting.