Effects of embedded micro-mindfulness on psychological symptoms in patients with advanced cancer receiving palliative...

To evaluate changes in psychological distress, anxiety and depressive symptoms, sleep problems, and pain intensity associated with participation in an embedded micro-mindfulness program among patients with advanced cancer receiving palliative care, and to explore factors associated with psychological symptom response.

This single-center, prospective, non-randomized observational study included 243 patients with advanced cancer receiving palliative care at West China Hospital. Patients who participated in the departmental micro-mindfulness program in addition to usual care comprised the MM group (n = 121), whereas those who received usual care without participating in the program comprised the UC group (n = 122). Outcomes were assessed at baseline and weekly for 4 weeks. Primary outcomes were anxiety and depressive symptoms assessed using the GAD-7 and PHQ-9, respectively. Secondary outcomes included psychological distress assessed using the Distress Thermometer (DT), sleep problems assessed using the two-item Insomnia Severity Index (ISI-2), and pain intensity assessed using the Numeric Rating Scale (NRS).

Baseline characteristics were comparable between groups. Significant group × time interactions were observed for GAD-7 (P = 0.001), PHQ-9 (P = 0.002), DT (P < 0.001), and ISI-2 (P < 0.001), with greater reductions over time observed in the MM group. The group × time interaction for NRS was not significant (P = 0.371). In the MM group, 73 patients (60.3%) achieved psychological symptom response.

Embedded micro-mindfulness was associated with greater improvements in anxiety, depressive symptoms, psychological distress, and sleep problems, but not pain intensity. These findings support further evaluation of this brief program as a supportive-care strategy for patients with advanced cancer receiving palliative care.