Mindful gratitude journaling: psychological distress, quality of life and suffering in advanced cancer: a randomised controlled trial

Context Numerous studies have shown that gratitude can reduce stress and improve quality of life. Objective Our study aimed to examine the effect of mindful gratitude journaling on suffering, psychological distress and quality of life of patients with advanced cancer. Methods We conducted a parallel-group, blinded, randomised controlled trial at the University of Malaya Medical Centre, Malaysia. Ninety-two adult patients with advanced cancer, and an overall suffering score ≥4/10 based on the Suffering Pictogram were recruited and randomly assigned to either a mindful gratitude journaling group (N=49) or a routine journaling group (N=43). Results After 1 week, there were significant reductions in the overall suffering score from the baseline in both the intervention group (mean difference in overall suffering score=−2.0, 95% CI=−2.7 to −1.4, t=−6.125, p=0.000) and the control group (mean difference in overall suffering score=−1.6, 95% CI=−2.3 to −0.8, t=−4.106, p=0.037). There were also significant improvements in the total Hospital Anxiety and Depression Scale score (mean difference=−3.4, 95% CI=−5.3 to −1.5, t=−3.525, p=0.000) and the total Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being score (mean difference=7.3, 95% CI=1.5 to 13.1, t=2.460, p=0.014) in the intervention group after 7 days, but not in the control group. Conclusion The results provide evidence that 7 days of mindful gratitude journaling could positively affect the state of suffering, psychological distress and quality of life of patients with advanced cancer

Factorial validation of the Malay version of multidimension scale of perceived social support among a group of psychiatric patients

Introduction: There is increasing awareness of the contribution of perceived social support (PSS) to emotional and physical well-being. Numerous scales measuring PSS have been developed, including the widely used Multidimensional Scale of Perceived Social Support (MSPSS). The psychometric properties of the MSPSS have been demonstrated in diverse samples, however mostly are conducted in English. Malay is the official language in Malaysia, and this study was conducted to provide evidence of the validity and reliability of a Malay version MSPSS (MSPSS-M) suited for our population. Methods: This is a cross sectional study. The sociodemographic and clinical information of the selected patients from psychiatric outpatient clinic over a 3-month period, were obtained via predesigned questionnaire, interviews and medical records. Assessment of psychiatric symptoms and social support were measured by various instruments including the Brief Psychiatric Rating Scale (BPRS-E), Depressive, Anxiety and Stress Scale (DASS) and MSPSS-M. Results: Data were reported for 228 psychiatric outpatients with the mean age of 40.3 years old. The 3-factor structure of the MSPSS-M (significant others, family, and friends) fitted the data well. The MSPSS-M showed good internal consistency (Cronbach a of 0.89) and validity. The scores of the total subscales for MSPSS-M were negatively correlated with the depression subscale in DASS (p<0.05). BPRS was negatively correlated with significant others (P<0.01) compared to the other two subscales in MSPSS-M. Conclusions: The Malay version MSPSS (MSPSS-M) is a psychometrically valid instrument with high internal consistency, which is useful in assessing perceived social support in Malaysian population

Symptom reduction in palliative care from single session mindful breathing : a randomised controlled trial

Context There has been increasing evidence of the role of mindfulness-based interventions in improving various health conditions. However, the evidence for the use of mindfulness in the palliative care setting is still lacking. Objectives The objective of our study was to determine the efficacy of a single session of 20 min mindful breathing in alleviating multiple symptoms in palliative care. Methods Adult palliative care in patients with at least one symptom scoring ≥5/10 based on the Edmonton Symptom Assessment Scale (ESAS) were recruited from September 2018 to December 2018. Recruited patients were randomly assigned to either 20 min mindful breathing and standard care or standard care alone. Results Forty patients were randomly assigned to standard care plus a 20 min mindful breathing session (n=20) or standard care alone (n=20). There was statistically significant reduction of total ESAS score in the mindful breathing group compared with the control group at minute 20 (U=98, n 1 = n 2 = 20, mean rank 1 = 15.4, mean rank 2 = 25.6, median reduction 1 = 6.5, median reduction 2 = 1.5, z=−2.763, r=0.3, p=0.005). Conclusion Our results provided evidence that a single session of 20 min mindful breathing was effective in reducing multiple symptoms rapidly for palliative care patients