Mindfulness-Based Interventions and Homework Interference with Cancer Patients

Saturday, 7 November 2015

Jacquelyn Tracy Krug, MA, BSN, BA, RN
Nursing, Western Governors University, Battle Creek, MI, USA

Abstract:  A wealth of studies exist to the efficacy of mindfulness-based interventions with cancer patients but few reflect homework behaviors.  The aim of this study was to add to the literature by examining the pre-post intervention scores with the group membership variable eliminated and to explore interfering homework variables.

Research Problem: The need exist in further understanding the impact a mindfulness-based intervention has on the psychological and physical symptoms of a cancer patient.  Research has shown that two mindfulness-based approaches have been implemented with cancer patients, namely mindfulness-based stressed reduction (MBSR) and mindfulness-based cognitive therapy (MBCT).  Research maintains each intervention employs a positive influence on the cancer patient’s symptoms.  Further study is needed to rule out the influences of group membership as a positive influence on the patient’s outcomes and to further understand what variables interfere with the patient’s completion of their homework.  This study looked to explore the patient’s personal experience with a mindfulness-based intervention and the factors that interfered with the completion of weekly homework as part of the intervention.

Research Method: The methodological approach used for this research study was quasi experimental. Three instruments were utilized for the study comprising two Likert scales and a survey.  The participants were nine cancer patients recruited for a six-week mindfulness-based program consisting of both MBSR (Mindfulness-based Stress Reduction) and MBCT (Mindfulness-based Cognitive Therapy).  Each week the subjects were introduced to a new daily mindfulness exercise and were asked to monitor six variables before and after each exercise (the homework).  These variables were:  pain, sadness, shame, anger, fear, and joy.  The subjects also monitored six variables likely to interfere with homework completion: family obligation, motivation, overwhelmed, relationship, pain, and depression/mood.  The mindfulness exercises were as follows:  Breathing Mindfully, Inner-Outer Shuttle, Body Awareness, Safe Place Visualization, Loving Kindness, and Walking Mindfully. 

Results: A t-test analysis was completed on the pre and post intervention scores resulting in a significance of p<.05 in each category: pain (p<.000301), sadness (p<.000268), shame (p<.004028), anger (p<.000223), fear (p<.003262) and joy (p<.002928)).  A trending analysis also supports these findings. Reliability and validity were not attached to the homework findings, as the assessment tool was designed by the researcher and not yet tested.  It was found that subjects reported family obligation or motivation to interfere 67-68% of the time with the completion of their daily mindfulness homework.

Conclusion:  This research study proposed to further understand the impact a mindfulness-based intervention had on cancer patients’ emotions and pain levels and to learn the variables that interfered with their mindfulness homework completion. The findings did support that mindfulness-based interventions did have a positive impact on the cancer patients’ emotions and pain levels.  The findings also identified common variables that interfered with the subjects completing their mindfulness homework, namely, family obligations, motivation, and depression.  What the research doesn’t detail is the human side of the study.  One subject, who was terrified of needles, told the story of going to the hospital for a blood transfusion, a frequent ordeal, and said, “I just told myself to breathe and start at my toes and work my way up” and the fear and anxiety was at a level one nurse could handle!  Another subject was so taken with the mindfulness program that she passed it on to her family members to practice.  Still another shared that focusing on mindfulness helped prepare her for her medical appointments especially after being newly diagnosed with another cancer.  Yet, the most poignant story came from a subject who had just been informed by his doctors that there were no more options left for him; his response was, “What do I do now?  It’s all about perspective.  Isn’t it?  This stuff (mindfulness) is about the now so I just stick with what I have right now.”