ContextThere 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.ObjectivesThe 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.MethodsAdult 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.ResultsForty 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).ConclusionOur results provided evidence that a single session of 20 min mindful breathing was effective in reducing multiple symptoms rapidly for palliative care patients.

Objective Suffering is a common experience in palliative care. In our study, we aimed to determine the effect of 5‐min mindfulness of love on suffering and the spiritual quality of life of palliative care patients. Methods We conducted a parallel‐group, blinded, randomized controlled study at the University of Malaya Medical Centre (UMMC), Malaysia from February 2019 to April 2019. Sixty adult palliative care patients with an overall suffering score of 4/10 or above based on the Suffering Pictogram were recruited and randomly assigned to either the 5‐min mindfulness of love group (N = 30) or the 5‐min supportive listening group (N = 30). Results There were statistically significant improvements in the overall suffering score (mean difference = −2.9, CI = −3.7 to −2.1, t = −7.268, p = 0.000) and the total FACIT‐Sp‐12 score (mean difference = 2.9, CI = 1.5 to 4.3, t = 4.124, p = 0.000) in the intervention group compared to the control group. Conclusion The results provided evidence that 5‐min mindfulness of love could affect the actual state of suffering and the spiritual quality of life of palliative care patients.

Although suffering in palliative care has received increasing attention over the past decade, the psychological processes that underpin suffering remain relatively unexplored.ObjectiveTo understand the psychological processes involved in the experiencing of suffering at the end phase of life.MethodsSemistructured interviews were conducted with 20 palliative care inpatients from an academic medical centre in Kuala Lumpur, Malaysia. The transcripts were thematically analysed with NVIVO9.Results5 themes of psychological processes of suffering were generated: (1) perceptions, (2) cognitive appraisals, (3) hope and the struggles with acceptance, (4) emotions and (5) clinging. A model of suffering formation was constructed.ConclusionThe findings may inform the development of mechanism-based interventions in the palliation of suffering.