Effects and Implementation of a Mindfulness and Relaxation App for Cancer Patients: Mixed-Methods Feasibility Study
ABSTRACT
Background:
A cancer diagnosis and cancer treatment can cause high levels of distress, which is often not sufficiently addressed in standard medical care. Therefore, a variety of adjuvant non-pharmacological treatments have been suggested to reduce cancer patients’ distress. However, not all patients use those interventions because of limited access or being unaware. To overcome these barriers, mHealth might be a promising way to deliver respective adjuvant interventions.
Objective:
The aim of this study was to evaluate effects and the implementation of a mindfulness and relaxation app intervention for cancer patients as well as patients’ adherence to such an intervention.
Methods:
In this observational feasibility study with a mixed-methods approach, cancer patients were recruited online and through hospitals in Switzerland. All enrolled patients received access to a mindfulness and relaxation app. Patients completed self-reported outcomes (general health, health-related quality of life, anxiety, depression, distress, mindfulness, and fear of progression) at baseline, week 4, 10, and 20. The frequency of app exercise usage was gathered directly through the app in order to assess the adherence of patients. In addition, we conducted interviews with 5 health professionals for their thoughts on the implementation of the app intervention into standard medical care. We analyzed patients’ self-reported outcomes with linear mixed models (LMM) and qualitative data with content analysis.
Results:
A total of 100 cancer patients (74 female) with a mean age of 53.24 (SD 11.55) participated in the study, of which 25 patients used the app regularly until week 20. LMM analyses revealed an improvement in anxiety (P=.04), distress (P<.001), fatigue (P=.01), sleep disturbance (P=.02), quality of life (P=.03), and mindfulness (P<.001) over the course of 20 weeks. Further LMM analyses revealed a larger improvement of distress (P<.001), a moderate improvement of anxiety (P=.001), and depression (P=.03) in patients with high symptom levels in the respective domains. The interviews revealed that the health professionals perceived the app as a helpful addition to standard care. They also made suggestions for improvements, which could facilitate the implementation and adherence to such an app.
Conclusions:
This study indicates that a mindfulness and relaxation app for cancer patients can be a feasible and effective way to deliver a self-care intervention, especially for highly distressed patients. Future studies should investigate if the appeal of the app can be increased with more content and the effectiveness of such an intervention needs to be tested in a randomized controlled trial. Clinical Trial: German Clinical Trials Register, DRKS00010481, https://www.drks.de/drks_web/navigate.do?navigation Id=trial.HTML&TRIAL_ID=DRKS00010481
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