Mindfulness-based Interventions for Pain and Symptom Management in Adolescent Cancer: Systematic Review

Area of Science:

• Oncology
• Adolescent Health
• Integrative Medicine

Background:

• Adolescents (10-19 years) with cancer require specialized nursing care.
• Existing research often focuses on adults or isolated symptoms, not adolescent symptom clusters.
• This review specifically examines mindfulness approaches for symptom clusters in this unique population.

Purpose of the Study:

• To systematically review the effects of mindfulness-based interventions (MBIs) on pain, symptom cluster severity, and quality of life in adolescents undergoing cancer chemotherapy.
• To identify evidence gaps and inform future research and clinical practice in pediatric oncology.

Main Methods:

• A comprehensive literature search was conducted across major databases (Scopus, Embase, PubMed, CINAHL, ProQuest) for English and Thai publications from 2014-2024.
• Quality evaluation was performed using JBI appraisal tools by independent researchers.
• Quantitative synthesis used random-effects modeling to analyze data from controlled and uncontrolled studies.

Main Results:

• Three studies (n=141) met inclusion criteria, utilizing individualized mindfulness-based yoga protocols.
• Predominantly nonsignificant outcomes were observed across symptom measures, with high heterogeneity in uncontrolled studies.
• A modest enhancement in cancer-specific quality of life was noted in uncontrolled studies (SMD = -0.55, p = .05), but not in controlled comparisons. Evidence confidence was low to extremely low.

Conclusions:

• Current evidence suggests limited efficacy of MBIs for symptom management in adolescents with cancer.
• Significant evidence gaps exist regarding the effectiveness of MBIs in this population.
• Rigorous, age-appropriate, nursing-led interventions integrating mindfulness are needed for multidimensional symptom cluster management in pediatric oncology.