Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: May 26, 2020
Date Accepted: Sep 30, 2020
Mindfulness-Based Programs for Cancer Patients via eHealth and mHealth: A Systematic Review and Synthesis of Quantitative Research
ABSTRACT
Background:
Mindfulness-based programs delivered via eHealth mode (eMBPs) are on the rise in complex oncology and palliative care. However, we are still at the beginning of answering the questions of how effective eMBPs are and for whom, and what kinds of delivery modes are the most efficient.
Objective:
The present systematic review aimed to (a) examine the feasibility and effectiveness of eMBPs on improving mental health and well-being in cancer patients, (b) describe intervention characteristics and delivery modes of these programs and (c) discuss predictors of effectivity, adherence, and attrition.
Methods:
Four databases (PubMed, PsycINFO, Scopus, and Web of Knowledge) were searched using relevant search terms (eg mindfulness, program, eHealth, and neoplasm) and their variations. No restrictions were imposed on language or publication type.
Results:
A total of 20 published papers describing 17 original studies were included in this review. Generally, the results indicate that eMBPs have the potential to reduce levels of stress, anxiety, depression, fatigue, affectivity, mindfulness, posttraumatic growth, and pain, and improve some parameters of general health. The largest median of Cohen’s d effect sizes were observed in reducing anxiety and depression (within-subject: Mdn = -0.46; IQR = -0.77 to -0.33; between-group: Mdn = -0.4; IQR = -0.56 to -0.20) and posttraumatic growth (within-subject: Mdn = 0.42; IQR = 0.35-0.48; between-group: Mdn = 0.32; IQR = 0.22-0.39). The effectivity of eHealth MBP may be comparable to that of parallel face-to-face MBP in some cases. All studies that evaluated the feasibility of eMBPs reported that they are feasible for cancer patients. Potential predictors of eMBP efficacy, attrition, and adherence are discussed.
Conclusions:
Despite the fact that the effects of the reviewed studies were highly heterogeneous, the review provides evidence that eMBPs are an appropriate way for mindfulness practice to be delivered to cancer patients. Thus far, existing eMBPs have mostly been attempts to convert proven face-to-face mindfulness programs to eHealth mode. They have not yet fully exploited the potential of eHealth technology.
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