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

This systematic review aimed to examine how mindfulness approaches affect pain, symptom cluster severity, and quality of life among adolescents receiving cancer chemotherapy. Contrasting with prior syntheses emphasizing adult populations or isolated symptoms, this investigation specifically targets symptom clusters in adolescent cancer patients (aged 10-19 years), a unique population requiring specialized nursing care approaches given their distinct developmental characteristics.

A comprehensive literature evaluation was conducted across Scopus, Cochrane Embase, PubMed, CINAHL (EBSCOhost), and ProQuest databases for publications in English and Thai from 2014 to 2024. Independent researchers conducted quality evaluation using established JBI appraisal tools. Information was synthesized through quantitative analysis employing random-effects modeling to address methodological heterogeneity between controlled and uncontrolled investigations.

From 299 identified publications, three investigations (n = 141) satisfied inclusion requirements. Participants received individualized mindfulness-based yoga protocols incorporating breathing techniques, physical movements, and relaxation practices. Analysis revealed predominantly nonsignificant outcomes across symptom measures. Uncontrolled studies demonstrated considerable heterogeneity for pain (I² = 84%) and sleep (I² = 86%) with no overall meaningful effects. The randomized trial showed no significant between-group differences for symptom measures. Uncontrolled studies indicated modest enhancement in cancer-specific quality of life aspects (standardized mean difference [SMD] = -0.55, p = .05); however, controlled comparison revealed no significant between-group changes for quality of life indicators. Evidence confidence was rated as low to extremely low across all measures due to high heterogeneity.

This first systematic synthesis of MBIs for adolescent cancer populations identifies limited current efficacy but reveals critical evidence gaps. Findings highlight the need for rigorous, age-appropriate, nursing-led interventions that integrate mindfulness with other evidence-based strategies to address multidimensional symptom clusters in pediatric oncology care.

Pain management nurses play an integral role in advancing nonpharmacological approaches to symptom management for adolescents with cancer. Mindfulness-based interventions may have potential to enhance holistic care and support patients and families in coping with treatment-related symptoms; however, the current evidence base remains limited and of variable quality. Accordingly, these interventions should be interpreted with caution, and additional rigorous, nursing-led research is warranted to determine their efficacy, feasibility, and sustainability in pediatric oncology practice.

PROSPERO CRD42024538493.