Mindfulness-Based stress reduction in early palliative care for people with metastatic cancer: A mixed-method study

Effects of chronic stress on cancer development and the therapeutic prospects of adrenergic signaling regulation

Long-term chronic stress is an important factor in the poor prognosis of cancer patients. Chronic stress reduces the tissue infiltration of immune cells in the tumor microenvironment (TME) by continuously activating the adrenergic signaling, inhibits antitumor immune response and tumor cell apoptosis while also inducing epithelial-mesenchymal transition (EMT) and tumor angiogenesis, promoting tumor invasion and metastasis. This review first summarizes how adrenergic signaling activates intracellular signaling by binding different adrenergic receptor (AR) heterodimers. Then, we focused on reviewing adrenergic signaling to regulate multiple functions of immune cells, including cell differentiation, migration, and cytokine secretion. In addition, the article discusses the mechanisms by which adrenergic signaling exerts pro-tumorigenic effects by acting directly on the tumor itself. It also highlights the use of adrenergic receptor modulators in cancer therapy, with particular emphasis on their potential role in immunotherapy. Finally, the article reviews the beneficial effects of stress intervention measures on cancer treatment. We think that enhancing the body's antitumor response by adjusting adrenergic signaling can enhance the efficacy of cancer treatment.

How do mindfulness-based interventions promote coping and self-efficacy in patients with cancer: A systematic review of qualitative and quantitative data

OBJECTIVE

The purpose of this study was to review the existing quantitative and qualitative evidence regarding how mindfulness-based interventions (MBIs) help cope with cancer-related challenges and increase affected patients' perceived self-efficacy.

METHODS

A systematic literature search was conducted on PubMed, PsycInfo, PubPsych, and CINAHL. Quantitative, qualitative, and mixed methods studies were included if they (1) evaluated MBIs (2) for patients with cancer or cancer survivors (3) regarding their impact on coping with cancer and perceived self-efficacy. The reports were screened by two independent reviewers and conflicts were resolved by a third reviewer. The review was pre-registered on PROSPERO (CRD42022368765).

RESULTS

Findings from 28 reports of 19 quantitative studies, six qualitative studies, and three mixed-methods studies (total N = 1722) were extracted and integrated. The synthesis of quantitative data showed considerable heterogeneity in outcomes and measurement instruments. Most often reported were significant positive impacts of mindfulness on general coping skills, self-regulation, and perceived efficacy in coping with cancer. Qualitative interviews with patients supported those results. The three meta-themes identified were that MBI (1) provided patients with tools to use in stressful situations, (2) promoted a general change of mindset and (3) created a feeling of social connectedness.

CONCLUSIONS

The reviewed studies suggest that MBI can promote coping and enhance the perceived self-efficacy of patients with cancer. In the future, more research investigating the different aspects of coping and the potentially moderating role of self-efficacy could provide further insights with respect to how coping and self-efficacy related to MBI.

Re-imagining metastatic breast cancer care delivery: a patient-partnered qualitative study

PURPOSE

While significant progress in metastatic breast cancer (MBC) treatment has prolonged survival and improved prognosis, there remain substantial gaps in providing patient-centered supportive care. The specific care delivery needs for metastatic cancer differ from that of early-stage cancer due to the incurable nature and lifelong duration of the condition. The objective of this study was to assess how patients living with MBC would re-imagine cancer care delivery.

METHODS

This qualitative study was conducted in partnership with patient-led organizations Guiding Researchers and Advocates to Scientific Partnerships (GRASP) and Project Life, a nonprofit, online wellness community founded by patients with MBC for patients living with MBC. Virtual semi-structured interviews (n = 36) were conducted with Project Life members purposively sampled from the groups' overall membership. The interview guide contained items surrounding patients' lived experiences of MBC, greatest unmet needs related to care, and perspectives on virtual wellness community involvement. Interviews were coded using two-stage deductive and inductive analysis.

RESULTS

Three major themes for re-imagining cancer care delivery were identified, including holistic care, information needs, and conceptual shifts. Within these several subthemes emerged with patients re-imagining referrals to non-oncological services, caregiver support, acceptance of integrative medicine, streamlined clinical trial enrollment, curated quality patient resources, MBC-specific terminology and approaches, long-term life and goal-of-care planning, and patient-centered voice throughout.

CONCLUSION

People living with metastatic cancers have specific supportive care needs. These findings highlight patient-driven areas for re-imagination that are most salient for individuals with MBC.

The effectiveness of progressive muscle relaxation technique in reducing cancer-related pain among palliative care patients: A randomized controlled trial

Purpose

Cancer-related pain (CRP) is a common and distressing symptom experienced by many patients receiving palliative care. The purpose of this trial was to evaluate the effectiveness of the progressive muscle relaxation (PMR) technique in reducing CRP in patients receiving palliative care.

Methods

A total of 148 patients diagnosed with cancer and receiving palliative care were randomly allocated to either an intervention or control group. The intervention group received a 4-week daily course of PMR technique, while the control group received only usual care. Data was collected using a demographic and clinical characteristics form, as well as the Brief Pain Inventory (BPI). Blind evaluations were conducted prior to the start of the intervention (T0), at the end of the 4-week PMR intervention (T1), and at 1-month follow-up (T2).

Results

The results of this trial demonstrated a significant decrease in pain intensity scores for the PMR group compared to the control group at both T1 and T2 (p < 0.05). Furthermore, the PMR group also exhibited significant improvements in pain interference with general activity, mood, relations with others, sleep, and enjoyment of life scores compared to the control group at both T1 and T2 (p < 0.05).

Conclusion

The results of this trial suggest that the PMR technique may be an effective intervention for reducing pain intensity and improving pain interference with life activities in cancer patients receiving palliative care. However, further research is needed to provide more robust evidence for the effectiveness of this intervention.Clinical trial registration number: NCT04436705. Registered at ClinicalTrials.gov.

Learning From Cancer Patients Who Push on With Tenacity

Cancer survivors have unique life challenges that threaten their well-being. Concept building has identified fearless tenacity as a process that is critical to meaningful survival, by expanding understanding of how cancer survivors get along day by day as they transcend the course of cancer treatment and move beyond to pursue life purpose. This work establishes a foundation for nurses wishing to promote self-worth through fostering fearless tenacity. It sets a direction for research and practice grounded in the discipline through a specific nursing theory and solid footing from both extant literature and the real life experiences.

Top Ten Tips Palliative Care Clinicians Should Know About Behavioral Pain Management for Persistent Pain

Seriously ill patients often experience persistent pain. As a part of a comprehensive repertoire of pain interventions, palliative care clinicians can help by using behavioral pain management. Behavioral pain management refers to evidence-based psychosocial interventions to reduce pain intensity and enhance functional outcomes and quality of life. Conceptualized using the biopsychosocial model, techniques involve promoting helpful behaviors (e.g., activity pacing, stretching, and relaxation exercises) and modifying underlying patterns of thinking, feeling, and communicating that can exacerbate pain. The authors have expertise in pain management, clinical health psychology, geropsychology, behavioral science, and palliative medicine. The article reviews the current evidence for behavioral interventions for persistent pain and provides 10 recommendations for behavioral pain management.

The Introspective Patient Experience of Mistletoe Therapy in Cancer: A Qualitative Study

INTRODUCTION

The introspective experience of cancer patients using mistletoe therapy has received little scientific interest, although it is crucial for a holistic understanding of this therapy. This study contributes to patient-centered research and treatment by documenting the subjective experiences of individuals undergoing mistletoe therapy.

METHODS

In this qualitative, explorative study, 20 outpatients with a history of various cancer types were recruited from Arlesheim Hospital (Arlesheim, Switzerland). All patients received subcutaneous mistletoe therapy for at least 2 years (median 7.5 years). Data was collected through 2 semi-structured, in-depth interviews per patient. Qualitative content analysis was applied to examine the data. The individual experience of mistletoe therapy was analyzed in relation to 6 predefined levels of human experience: physical, vital, emotional, mental, spiritual and social. In addition, 3 further aspects, considered as cross-dimensional perspectives, emerged out of the material: warmth, immune strengthening, and general wellbeing.

RESULTS

Data analysis revealed considerable heterogeneity among patients' experiences with mistletoe therapy. The importance of specific aspects became apparent, such as increased vitality to manage daily life, greater emotional and mental stability, warmth as a multidimensional phenomenon, feelings of safety and protection through mistletoe therapy, heightened self-awareness and improved self-care, as well as sensations of spiritual connectedness.

CONCLUSIONS

Prior to this study it had not been shown that cancer patients using mistletoe therapy do have observations on different levels of experience. These results may lead to a deeper understanding of patients receiving mistletoe therapy, enabling them to be supported in a more holistic way both during mistletoe treatment and on their life path. Further investigations into the effects of mistletoe therapy on the emotional, mental, and spiritual level are warranted.

Stress and cancer: The mechanisms of immune dysregulation and management

Advances in the understanding of psychoneuroimmunology in the past decade have emphasized the notion that stress and cancer are interlinked closely. Durable chronic stress accelerated tumorigenesis and progression, which is unfavorable for clinical outcomes of cancer patients. Available evidence has provided unprecedented knowledge about the role and mechanisms of chronic stress in carcinogenesis, the most well-known one is dysfunction of the hypothalamus-pituitary-adrenal (HPA) axis and the sympathetic nervous system (SNS). With abnormal activation of neuroendocrine system, stress-related hormones contribute to increased oncogenes expression, exacerbated chronic inflammation and impaired immunologic function. In addition, accumulating studies have demonstrated that diverse stress interventions including pharmacological approaches, physical exercises and psychological relaxation have been administered to assist in mental disorders reduction and life quality improvement in cancer patients. In this review, we systematically summarize the connection and mechanisms in the stress-immune-cancer axis identified by animal and clinical studies, as well as conclude the effectiveness and deficiencies of existing stress management strategies.

Hybrid laser activated phycocyanin/capecitabine treatment of cancerous MCF7 cells

Laser-induced fluorescence is recently used as an efficient technique in cancer diagnosis and non-invasive treatment. Here, the synergic therapeutical efficacies of the Capecitabine (CAP) chemodrug, photosensitive Phycocyanin (PC) and graphene oxide (GO) under laser irradiation were investigated. The therapeutical efficacies of diverse concentrations of CAP (0.001-10 mg/ml) and PC (0.5-10 mg/ml) alone and with laser irradiation on human breast adenocarcinoma (MCF-7) cells were examined. The interactional effects of 100 mW SHG Nd:YAG laser at 532nm and GaAs laser at 808 nm ranging power of 150 mW- 2.2W were considered. The contribution of graphene oxide (GO) in biocompatible concentrations of 2.5-20 ng/ml and thermal characteristics of laser exposure at 808 nm on GO + fluorophores have been studied. The effects of the bare and laser-excited CAP + PC on cell mortality have been obtained. Despite the laser irradiation could not hold up the cell proliferation in the absence of drug interaction considerably; however, the viability of the treated cells (by a combination of fluorophores) under laser exposure at 808 nm was significantly reduced. The laser at 532 nm excited the fluorescent PC in (CAP + PC) to trigger the photodynamic processes via oxygen generation. Through the in-vitro experiments of laser-induced fluorescence (LIF) spectroscopy of PC + CAP, the PC/CAP concentrations of the maximum fluorescence signal and spectral shifts have been characterized. The synergic effects of the laser exposures and (CAP + PC) treatment at different concentrations were confirmed. It has been shown here that the laser activation of (CAP + PC) can induce the mortality of the malignant cells by reducing the chemotherapeutic dose of CAP to avoid its non-desirable side effects and by approaching the minimally invasive treatment. Elevation of the laser intensity/exposure time could contribute to the therapeutic efficacy. Survival of the treated cells with a combination of GO and fluorophores could be reduced under laser exposure at 808 nm compared to the same combination therapy in the absence of GO. This survey could benefit the forthcoming clinical protocols based on laser spectroscopy for in-situ imaging/diagnosis/treatment of adenocarcinoma utilizing PC + CAP + GO.

Psychological interventions targeting patients with metastatic cancer and prolonged survival expectancies: advances and challenges

PURPOSE OF REVIEW

The purpose of this article is to review the formats and techniques of psychological interventions designed for patients with metastatic cancer and prolonged survival expectancies.

RECENT FINDINGS

Fifteen interventional studies were selected for this article. One group of psychological interventions focused primarily on patients' adaptation by increasing their knowledge, developing patients' stress management skills, promoting their open communication with healthcare providers, and helping them deal with existential concerns. Another group of interventions focused on patients with moderate and high levels of distress. These interventions provided specific techniques to manage anxiety, depression, fear of cancer progression, and existential distress. Interestingly, interventions targeting distressed patients are not necessarily longer or more intensive than interventions targeting adaptation. The interventions were examined in few randomized controlled trials, and incorporated a broad range of techniques, making comparison of their efficacy difficult. No intervention specifically targeted patients newly diagnosed with metastatic cancer.

SUMMARY

On the basis of this review, we proposed suggestions according to patients' levels of distress, which differ in intensity, format, techniques, and tools offered. These suggestions may be relevant for the future development and assessment of interventions targeting patients with newly diagnosed metastatic cancer and prolonged survival expectancies.

The Source of Life: Meditation and Spirituality in Healthcare for a Comprehensive Approach to The COVID-19 Syndemic

The COVID-19 syndemic has raised many unanswered questions about the most important values in human life. It has revealed  the limits of looking at mere survival and ignoring closeness, spirituality, and "connectedness". Spiritual accompaniment, in contrast, is a valid therapeutic tool for individuals suffering from  life-threatening diseases, allowing a real recovery of the transcendent dimension of existence which retrieves one's relationship with the mystery, and reintegrates illness and death within one's horizon of thought. According to this vision, in the field of healthcare, people experienced in spiritual accompaniment may support patients through their disease journey by strengthening  their resilience; this was extended in 2020 with telematic assistance, to patients with COVID-19, with very positive results. This gave impetus to the project to rebuild a rural village, suitable for pursuing the principles of green therapy (also known as echotherapy) in order to host patients in various stages of life-threatening illness  who wish to deepen their spiritual search by receiving expert, non-confessional spiritual accompaniment, by living side by side with families and resident monks; there will also be a hospice oriented towards spiritual assistance, to accommodate patients in advanced stages of illness. The spiritual accompaniment proposed here is centered on meditation and is part of a historic tradition, although it is promoted with language adapted to the modern era. This has for decades helped many people following this path.

Spiritual interventions for cancer pain: a systematic review and narrative synthesis

BackgroundPain is a common and debilitating cancer-related symptom. In palliative care, physical, psychological, social and spiritual factors are thought to contribute to individual experience of pain. Consequently, spiritual care interventions are advocated in the management of cancer-related pain.

AIM

To systematically review the published literature concerning spiritual interventions in the management of cancer-related pain.

METHODOLOGY

Seven databases (Medline, CINAHL, EMBASE, PsycINFO, Cochrane, Scopus and Web of Science) were searched for quantitative studies of pain in patients with cancer receiving spiritual care interventions, with additional reference and citation searches. Research quality and relevance was appraised using Gough's 'Weight of Evidence' framework prior to narrative synthesis.

RESULTS

The search identified 12 822 articles, of which 11 were included in the synthesis. Few studies have investigated spiritual interventions in the management of cancer pain: a minority of these demonstrate statistical benefit. Some evidence suggests spiritual care may aid in coping with pain, rather than altering pain intensity. Spiritual interventions are well received by patients with cancer and do not appear to cause harm.

CONCLUSION

Current evidence provides limited support for the use of spiritual care interventions in the management of cancer pain. The paucity and heterogeneity of literature points to a need for high-quality research with judgements of spiritual intervention efficacy made on an individual basis.

PROSPERO REGISTRATION NUMBER

CRD42020190194.

Wondering Awe as a Perceptive Aspect of Spirituality and Its Relation to Indicators of Wellbeing: Frequency of Perception and Underlying Triggers

Background: Spirituality is a multidimensional construct which includes religious, existentialistic, and relational issues and has different layers such as faith as the core, related attitudes and conviction, and subsequent behaviors and practices. The perceptive aspects of spirituality such as wondering awe are of relevance for both, religious and non-religious persons. These perceptions were related to perceiving the Sacred in life, mindful awareness of nature, others and self, to compassion, meaning in life, and emotional wellbeing. As awe perceptions are foremost a matter of state, it was the aim (1) to empirically analyze the frequency of wondering awe perceptions (i.e., with respect to gender, age cohorts, religious or non-religious persons) and (2) to qualitatively analyze a range of triggers of awe perceptions.

Methods: Data from 7,928 participants were analyzed with respect to the frequency of Awe/Gratitude perceptions (GrAw-7 scale), while for the second part of the study responses of a heterogeneous group of 82 persons what caused them to perceive moments of wondering awe were analyzed with qualitative content analysis techniques.

Results: Persons who experience Awe/Gratitude to a low extend were the youngest and had lowest wellbeing and lowest meditation/praying engagement, while those with high GrAw-7 scores were the oldest, had the highest wellbeing, and were more often meditating or praying (p<0.001). Gender had a significant effect on these perceptions, too (Cohen’s d=0.32). In the qualitative part, the triggers can be attributed to four main categories, Nature, Persons, Unique Moments, and Aesthetics, Beauty, and Devotion. Some of these triggers and related perceptions might be more a matter of admiration than wondering awe, while other perceptions could have more profound effects and may thus result in changes of a person’s attitudes and behaviors.

Conclusion: Emotionally touching experiences of wondering awe may result in feelings of interconnectedness, prosocial behavior, mindful awareness, and contribute to a person’s meaning in life and wellbeing and can also be a health-relevant resource. These perceptions can be seen as a perceptive aspect of spirituality, which is not exclusively experienced by religious people but also by non-religious persons.

Pain regulation during mindfulness meditation: Phenomenological fingerprints in novices and experts practitioners

BACKGROUND

The way people respond to pain is based on psychological mechanisms, beliefs and expectations. Mindfulness meditation (MM) has been shown to regulate pain and mental suffering through different mechanisms such as positive reappraisal, attentional and emotional regulation. Yet, subjective experience and meaning of pain in connection with MM are still largely unexplored.

METHODS

The present mixed-methods study combined an interpretative-phenomenological qualitative approach with an experimental thermal pain paradigm to explore and compare the meaning of experiencing pain in 32 novices who received short meditation training and 30 experts in meditation practice (more than 10, 000 hr in life). We collected the qualitative data during in-depth semi-structured interviews where we probed participants' response strategies. During the pain task, we collected self-reports of intensity and unpleasantness, while after the task we collected self-reports of avoidance, openness, vividness and blissfulness.

RESULTS

Five phenomenological clusters (PhC) emerged from the interviews, including three which described pain as an unpleasant sensation calling for: (1) experiential avoidance-suppression, (2) volitional agency-distanciation, or (3) a positive cognitive reappraisal and flexibility. Two additional clusters (4-5), containing mostly expert meditators, thematized pain sensation as an opportunity to gain metacognitive insights about mental processes, and to deconstruct one's suffering through these insights. PhC5 further integrates these insights with the recognition that suffering is part of the shared human experience and with the aspiration to relieve others from suffering. Each PhC was correlated to a unique profile of self-reports during the pain paradigm.

CONCLUSION

These findings need to be replicated in patients and practicing MM. They also warrant the integration of this mixed-method approach with brain imaging data to refine the experiential neuroscience of pain.

SIGNIFICANCE

We compared the meaning of experiencing and regulating pain in novices and expert meditators using qualitative interviews. We identified five phenomenological clusters describing relevant features implicated in pain response strategies and meditation. These clusters were organized along a pseudo-gradient, which captured meditation expertise and predicted self-reports related to a pain paradigm and psychometric scales associated with pain and its regulation. These findings advance our understanding of the metacognitive mechanisms and beliefs underlying mindfulness meditation and can inform pain treatment strategies.

Cancer and stress: NextGen strategies

Chronic stress is well-known to cause physiological distress that leads to body balance perturbations by altering signaling pathways in the neuroendocrine and sympathetic nervous systems. This increases allostatic load, which is the cost of physiological fluctuations that are required to cope with psychological challenges as well as changes in the physical environment. Recent studies have enriched our knowledge about the role of chronic stress in disease development, especially carcinogenesis. Stress stimulates the hypothalamic-pituitaryadrenal (HPA) axis and the sympathetic nervous system (SNS), resulting in an abnormal release of hormones. These activate signaling pathways that elevate expression of downstream oncogenes. This occurs by activation of specific receptors that promote numerous cancer biological processes, including proliferation, genomic instability, angiogenesis, metastasis, immune evasion and metabolic disorders. Moreover, accumulating evidence has revealed that β-adrenergic receptor (ADRB) antagonists and downstream target inhibitors exhibit remarkable anti-tumor effects. Psychosomatic behavioral interventions (PBI) and traditional Chinese medicine (TCM) also effectively relieve the impact of stress in cancer patients. In this review, we discuss recent advances in the underlying mechanisms that are responsible for stress in promoting malignancies. Collectively, these data provide approaches for NextGen pharmacological therapies, PBI and TCM to reduce the burden of tumorigenesis.

Mindfulness-Based Interventions in Cancer Survivors: A Systematic Review of Participants' Adherence to Home Practice

BACKGROUND

Although mindfulness-based interventions (MBIs) have demonstrated efficacy for alleviating psychological distress in cancer survivors, little is known about the extent to which participants adhere to assigned home practice. The purpose of this systematic review was to summarize and appraise the literature on rates and correlates of adherence to mindfulness home practice among cancer survivors.

METHODS

Four databases (PubMed, Psychology and Behavioral Sciences, PsycInfo, and CINAHL) were searched for studies published before October 15, 2020. Articles were included if they evaluated the benefits of an MBI program for adults with cancer.

RESULTS

Twenty-one studies (N=1811 participants) meeting the inclusion criteria were identified (randomized controlled trials (n=13), non-randomized controlled designs (n=2), single-group studies (n=6)). The pooled adherence rate for participants' home practice was 60% of the assigned amount, which equated to 27 min per day during the intervention period. There was some evidence for a relationship between home practice of mindfulness techniques and improvements in mood, stress, anxiety, depression, and fear of cancer recurrence (correlation coefficients ranged from 0.33 to 0.67). Factors including marital status, mood disturbance at baseline, intervention modality, and personality traits were evaluated in relation to adherence to home practice, but the current literature was inadequate to evaluate whether a relationship exists.

CONCLUSION

Adherence to mindfulness home practice among cancer survivors is suboptimal, and most of the correlates of adherence studied to date are non-modifiable. More research is warranted to scrutinize the role of home practice in mindfulness-based interventions, including assessment of modifiable factors influencing adherence to improve benefits for this population.

A scoping review of studies exploring leisure-time physical activity in adults diagnosed with advanced cancer

OBJECTIVES

Despite improving survival rates, people with advanced cancer face several physical and psychosocial concerns. Leisure-time physical activity (LPA) has been found to be beneficial after cancer diagnosis, but little is known about the current state of research exploring LPA in advanced cancer. Our objectives were to (a) map the literature examining LPA in people with advanced cancer, (b) report on the terms used to describe the advanced cancer population within the literature, and (c) examine how the concept of LPA is operationalized within the literature.

METHOD

Our scoping review followed Arksey and O'Malley's methodological framework. We performed a search of 11 electronic databases and supplementary sources (February 2018; database search updated January 2020). Two reviewers independently reviewed and selected articles according to the inclusion criteria: English-language journal articles on original primary research studies exploring LPA in adults diagnosed with advanced cancer. Descriptive and thematic analyses were performed.

RESULTS

Ninety-two articles met our criteria. Most included studies were published in the last decade (80%) and used quantitative methods (77%). Many study populations included mixed (40%), breast (21%), or lung (17%) cancers. Stages 3-4 or metastatic disease were frequently indicated to describe study populations (77%). Several studies (68%) described LPA programs or interventions. Of these, 78% involved structured aerobic/resistance exercise, while 16% explored other LPA types.

SIGNIFICANCE OF RESULTS

This review demonstrates a recent surge in research exploring LPA in advanced cancer, particularly studies examining exercise interventions with traditional quantitative methods. There remains insufficient knowledge about patient experiences and perceptions toward LPA. Moreover, little is known about other leisure activities (e.g., Tai Chi, dance, and sports) for this population. To optimize the benefits of LPA in people with advanced cancer, research is needed to address the gaps in the current literature and to develop personalized, evidence-based supportive care strategies in cancer care.

Effects of eight weeks of simple mindfulness stress reduction training on anxiety, depression, and sleep quality in elderly patients with functional dyspepsia

BACKGROUND

Functional dyspepsia (FD) tends to cause anxiety and depression in patients and affect their sleep quality. Mental and psychological factors play an important role in the development of FD. Therefore, it is necessary to strengthen the understanding of the psychological status of FD patients to better implement targeted intervention measures to reduce negative emotions and improve sleep quality.

AIM

To observe the effects of 8 wk of simple mindfulness stress reduction training on anxiety, depression, and sleep quality in elderly patients with FD.

METHODS

Ninety elderly FD patients admitted to The Second Hospital of Jinhua, Zhejiang Province from March 2017 to June 2019 were selected as study subjects, and they were randomly divided into either a control group or an observation group, each with 45 cases. Both groups received routine care, and the observation group was additionally given 8 wk of simple mindfulness stress reduction training intervention. Changes in anxiety and depression scores, Pittsburgh sleep quality index score, sleep latency, and sleep duration were recorded before and after intervention.

RESULTS

Self-rating anxiety scale and self-rating depression scale scores in the two groups were significantly lower than those in the control group (P < 0.05). Compared with those before intervention, sleep quality was significantly improved (P < 0.05), sleep latency was significantly shortened (P < 0.05), and sleep duration was significantly prolonged (P < 0.05) in both groups after intervention; the observation group was significantly better than the control group in these indexes (P < 0.05).

CONCLUSION

Eight weeks of simple mindfulness stress reduction training can effectively relieve anxiety, depression, and other negative emotions and improve sleep quality in elderly patients with FD.