Abstract
BackgroundeHealth mindfulness-based programs (eMBPs) are on the rise in complex oncology and palliative care. However, we are still at the beginning of answering the questions of how effective eMBPs are and for whom, and what kinds of delivery modes are the most efficient.ObjectiveThis systematic review aims to examine the feasibility and efficacy of eMBPs in improving the mental health and well-being of patients with cancer, to describe intervention characteristics and delivery modes of these programs, and to summarize the results of the included studies in terms of moderators, mediators, and predictors of efficacy, adherence, and attrition.MethodsIn total, 4 databases (PubMed, PsycINFO, Scopus, and Web of Knowledge) were searched using relevant search terms (eg, mindfulness, program, eHealth, neoplasm) and their variations. No restrictions were imposed on language or publication type. The results of the efficacy of eMBPs were synthesized through the summarizing effect estimates method.Results A total of 29 published papers describing 24 original studies were included in this review. In general, the results indicate that eMBPs have the potential to reduce the levels of stress, anxiety, depression, fatigue, sleep problems, and pain, and improve the levels of mindfulness, posttraumatic growth, and some parameters of general health. The largest median of Cohen d effect sizes were observed in reducing anxiety and depression (within-subject: median −0.38, IQR −0.62 to −0.27; between-group: median −0.42, IQR −0.58 to −0.22) and facilitating posttraumatic growth (within-subject: median 0.42, IQR 0.35 to 0.48; between-group: median 0.32, IQR 0.22 to 0.39). The efficacy of eMBP may be comparable with that of parallel, face-to-face MBPs in some cases. All studies that evaluated the feasibility of eMBPs reported that they are feasible for patients with cancer. Potential moderators, mediators, and predictors of the efficacy, attrition, and adherence of eMBPs are discussed. ConclusionsAlthough the effects of the reviewed studies were highly heterogeneous, the review provides evidence that eMBPs are an appropriate way for mindfulness practice to be delivered to patients with cancer. Thus far, existing eMBPs have mostly attempted to convert proven face-to-face mindfulness programs to the eHealth mode. They have not yet fully exploited the potential of eHealth technology.
Highlights
BackgroundCancer is the second leading cause of death in the world, and approximately 1 in 6 deaths is because of this disease [1]
Conclusions: the effects of the reviewed studies were highly heterogeneous, the review provides evidence that eHealth mindfulness-based programs (eMBPs) are an appropriate way for mindfulness practice to be delivered to patients with cancer
Vast heterogeneity in the intervention and population characteristics was found in the reviewed literature, most of the studies suggested that eHealth is an appropriate way to deliver proven mindfulness effects to patients with cancer
Summary
BackgroundCancer is the second leading cause of death in the world, and approximately 1 in 6 deaths is because of this disease [1]. The prevalence of major depressive disorders is approximately 15% in patients with advanced cancer [3], and 30% to 40% of patients in various stages of cancer development report significant psychosocial distress symptoms, such as anxiety, depression, nervousness, and insomnia [4,5,6]. The management of these psychiatric symptoms, especially of distress related to the cancer diagnosis, is one of the main challenges of complex oncological and palliative care. We are still at the beginning of answering the questions of how effective eMBPs are and for whom, and what kinds of delivery modes are the most efficient
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