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Background: The number of patients living with cancer is growing, and a substantial number of patients suffer from psychological distress. Mindfulness-based interventions (MBIs) seem effective in alleviating psychological distress. Unfortunately, several cancer patients find it difficult, if not impossible, to attend a group-based course. Internet-based MBIs (eMBIs) such as Internet-based mindfulness-based cognitive therapy (eMBCT) may offer solutions. However, it is yet to be studied what facilitators and barriers cancer patients experience during eMBCT.Objective: This study aimed to explore facilitators and barriers of individual asynchronous therapist-assisted eMBCT as experienced by both patients and therapists.
Methods: Patients with heterogeneous cancer diagnoses suffering from psychological distress were offered eMBCT. This 9-week intervention mirrored the group-based MBCT protocol and included weekly asynchronous written therapist feedback. Patients were granted access to a website that contained the eMBCT protocol and a secured inbox, and they were asked to practice and fill out diaries on which the therapist provided feedback. In total, 31 patients participated in an individual posttreatment interview on experienced facilitators and barriers during eMBCT. Moreover, eight therapists were interviewed. The data were analyzed with qualitative content analysis to identify barriers and facilitators in eMBCT.
Results: Both patients and therapists mentioned four overarching themes as facilitators and barriers: treatment setting (the individual and Internet-based nature of the treatment), treatment format (how the treatment and its guidance were organized and delivered), role of the therapist, and individual patient characteristics.
Conclusions: The eMBCT provided flexibility in when, where, and how patients and therapists engage in MBCT. Future studies should assess how different eMBCT designs could further improve barriers that were found.
Background: The number of patients living with cancer is growing, and a substantial number of patients suffer from psychological distress. Mindfulness-based interventions (MBIs) seem effective in alleviating psychological distress. Unfortunately, several cancer patients find it difficult, if not impossible, to attend a group-based course. Internet-based MBIs (eMBIs) such as Internet-based mindfulness-based cognitive therapy (eMBCT) may offer solutions. However, it is yet to be studied what facilitators and barriers cancer patients experience during eMBCT.Objective: This study aimed to explore facilitators and barriers of individual asynchronous therapist-assisted eMBCT as experienced by both patients and therapists.
Methods: Patients with heterogeneous cancer diagnoses suffering from psychological distress were offered eMBCT. This 9-week intervention mirrored the group-based MBCT protocol and included weekly asynchronous written therapist feedback. Patients were granted access to a website that contained the eMBCT protocol and a secured inbox, and they were asked to practice and fill out diaries on which the therapist provided feedback. In total, 31 patients participated in an individual posttreatment interview on experienced facilitators and barriers during eMBCT. Moreover, eight therapists were interviewed. The data were analyzed with qualitative content analysis to identify barriers and facilitators in eMBCT.
Results: Both patients and therapists mentioned four overarching themes as facilitators and barriers: treatment setting (the individual and Internet-based nature of the treatment), treatment format (how the treatment and its guidance were organized and delivered), role of the therapist, and individual patient characteristics.
Conclusions: The eMBCT provided flexibility in when, where, and how patients and therapists engage in MBCT. Future studies should assess how different eMBCT designs could further improve barriers that were found.
Background: The number of patients living with cancer is growing, and a substantial number of patients suffer from psychological distress. Mindfulness-based interventions (MBIs) seem effective in alleviating psychological distress. Unfortunately, several cancer patients find it difficult, if not impossible, to attend a group-based course. Internet-based MBIs (eMBIs) such as Internet-based mindfulness-based cognitive therapy (eMBCT) may offer solutions. However, it is yet to be studied what facilitators and barriers cancer patients experience during eMBCT.Objective: This study aimed to explore facilitators and barriers of individual asynchronous therapist-assisted eMBCT as experienced by both patients and therapists.
Methods: Patients with heterogeneous cancer diagnoses suffering from psychological distress were offered eMBCT. This 9-week intervention mirrored the group-based MBCT protocol and included weekly asynchronous written therapist feedback. Patients were granted access to a website that contained the eMBCT protocol and a secured inbox, and they were asked to practice and fill out diaries on which the therapist provided feedback. In total, 31 patients participated in an individual posttreatment interview on experienced facilitators and barriers during eMBCT. Moreover, eight therapists were interviewed. The data were analyzed with qualitative content analysis to identify barriers and facilitators in eMBCT.
Results: Both patients and therapists mentioned four overarching themes as facilitators and barriers: treatment setting (the individual and Internet-based nature of the treatment), treatment format (how the treatment and its guidance were organized and delivered), role of the therapist, and individual patient characteristics.
Conclusions: The eMBCT provided flexibility in when, where, and how patients and therapists engage in MBCT. Future studies should assess how different eMBCT designs could further improve barriers that were found.
Introduction: About one‐third of cancer survivors suffer from severe chronic fatigue. Aim of this study was to evaluate the efficacy of mindfulness‐based cognitive group therapy in reducing severe chronic fatigue in cancer survivors with mixed diagnoses.Patients and Methods: Participants (n = 100) were randomly selected from a cohort and allocated to an intervention and a waiting list condition. Analyses were based on 59 participants in the intervention condition and 24 in the waiting‐list condition. Fatigue severity (Checklist Individual Strength), functional impairment (Sickness Impact Profile) and well being (Health and Disease‐Inventory) were assessed before and after the 9‐week intervention. The intervention group had a follow‐up 6 months following the intervention.
Results: At post‐treatment measurement the proportion of clinically improved participants was 30%, versus 4% in the waiting list condition (χ2 (1) = 6.71; p = 0.007). The mean fatigue score at post‐measurement was significantly lower in the intervention group than in the waiting list group corrected for pre‐treatment level of fatigue. The mean well‐being score at post‐measurement was significantly higher in the intervention group than in the waiting list group corrected for pre‐treatment level of well‐being. The treatment effect was maintained at 6‐month follow‐up. No difference between the two conditions was found in functional impairment.
Most validation studies of the Freiburg Mindfulness Inventory (FMI) involved healthy subjects. Validation in patients who suffer from a life-threatening medical illness is needed, to investigate the FMI’s validity in medical psychology research and practice. Psychometric properties of the Dutch FMI were examined in two patient groups of two different studies: (Sample 1) cardiac patients (n = 114, M age = 56 ± 7 years, 18% women) and (Sample 2) severely fatigued cancer survivors (n = 158, M age = 50 ± 10 years, 77% women). Confirmatory factor analysis (studied only in Sample 2) provided good fit for the two-factor solution (Acceptance and Presence), while the one-factor solution provided suboptimal fit indices. Internal consistency was good for the whole scale in both samples (Sample 1 α = .827 and Sample 2 α = .851). The two-factor model showed acceptable to good internal consistency in Sample 2 (Presence: α = .823; Acceptance α = .744), but poor to acceptable in Sample 1 (Presence subscale: α = .577, Acceptance subscale: α = .791). Clinical sensitivity was supported in both samples, and construct validity (studied only in Sample 1) was acceptable. The Dutch FMI is an acceptable instrument to measure mindfulness in patients who experienced a life-threatening illness in a Dutch-speaking population.
Most validation studies of the Freiburg Mindfulness Inventory (FMI) involved healthy subjects. Validation in patients who suffer from a life-threatening medical illness is needed, to investigate the FMI’s validity in medical psychology research and practice. Psychometric properties of the Dutch FMI were examined in two patient groups of two different studies: (Sample 1) cardiac patients (n = 114, M age = 56 ± 7 years, 18% women) and (Sample 2) severely fatigued cancer survivors (n = 158, M age = 50 ± 10 years, 77% women). Confirmatory factor analysis (studied only in Sample 2) provided good fit for the two-factor solution (Acceptance and Presence), while the one-factor solution provided suboptimal fit indices. Internal consistency was good for the whole scale in both samples (Sample 1 α = .827 and Sample 2 α = .851). The two-factor model showed acceptable to good internal consistency in Sample 2 (Presence: α = .823; Acceptance α = .744), but poor to acceptable in Sample 1 (Presence subscale: α = .577, Acceptance subscale: α = .791). Clinical sensitivity was supported in both samples, and construct validity (studied only in Sample 1) was acceptable. The Dutch FMI is an acceptable instrument to measure mindfulness in patients who experienced a life-threatening illness in a Dutch-speaking population.