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

Tan, Ting; Tan, Maw Pin; Lam, Chee Loong; Loh, Ee Chin; Capelle, David Paul; Zainuddin, Sheriza Izwa; Ang, Bin Ting; Lim, Min Ai; Lai, Natalie Zi; Tung, Yu Zhen; Yee, Anne; Ng, Chong Guan; Ho, Gwo Fuang; See, Mee-Hoong; Teh, Mei-Sze; Lai, Lee Lee; Singh, Rajesh Kumar; Chai, Chee-Shee; Ng, Diana Leh-Ching; Beng, Tan Seng

doi:10.1136/bmjspcare-2021-003068

Cited by 10 publications

(10 citation statements)

References 21 publications

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“…Indeed, several participants noted that our questionnaires did not echo their experience of the gratitude intervention ("your questionnaire had nothing to do with what I wrote"), which suggests that our choice of quantitative indicators was not optimal. Whilst our quantitative results are less encouraging than other gratitude intervention studies in oncology (15)(16)(17), the potential for comparison with this body of research remains limited insofar as our study and intervention designs differ from the latter (e.g. no control group, original gratitude intervention).…”

Section: Intervention Effectscontrasting

confidence: 61%

“…A recent randomised controlled trial with advanced cancer patients in Indonesia showed that a week-long mindful gratitude journaling intervention -i.e. daily gratitude listing and meditation on the objects of gratitude -helped patients experience less anxiety and depression and greater spiritual wellbeing than those who took part in a routine journaling intervention (17). By contrast, few studies have considered gratitude in palliative care contexts (18,19).…”

Section: Introductionmentioning

confidence: 99%

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Giving and receiving thanks: A mixed methods pilot study of a gratitude intervention for palliative patients and their carers

Bernard

Poncin

Bovet

et al. 2022

Preprint

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Background Psychological research examining the nature and workings of gratitude has burgeoned over the past two decades. However, few studies have considered gratitude in the palliative care context. Based on an exploratory study which found that gratitude was correlated with better quality of life and less psychological distress in palliative patients, we designed and piloted a gratitude intervention where palliative patients and a carer of their choice wrote and shared a gratitude letter with each other. The aims of this study are to establish the feasibility and acceptability of our gratitude intervention and provide a preliminary assessment of its effects. Methods This pilot intervention study adopted a mixed-methods, pre-post evaluation design. To assess the intervention’s effects, we employed quantitative questionnaires on quality of life, quality of relationship, psychological distress, and subjective burden, as well as semi-structured interviews. To assess feasibility, we considered patients and carers’ eligibility, participation and attrition rates, reasons for refusal to participate, appropriateness of intervention timeframe, modalities of participation, and barriers and facilitators. Acceptability was assessed through post-intervention satisfaction questionnaires. Results Thirty-nine participants completed the intervention. We did not find any statistically significant pre/post intervention changes for patients, but found significant decrease in psychological distress for carers in terms of depression (median = 3 at T0, 1.5 at T1, p = .034) and total score (median = 13 at T0, 7.5 at T1, p = .041). Qualitative analysis indicates that overall, the intervention had: (1) multiple positive outcomes for 11 participants, in the form of positive emotional, cognitive, and relational effects; (2) simple positive outcomes for 14 participants, who experienced emotional or cognitive effects; (3) no effect on two patients; and (4) negative emotional effects on two patients. Feasibility and acceptability indicators suggest that the intervention was well received by participants, and that it should adopt flexible modalities (e.g. writing or dictating a gratitude message) to ensure that it is feasible and adapted to individual needs and preferences. Conclusions Larger scale deployment and evaluation of the gratitude intervention, including a control group, is warranted in order to have a more reliable evaluation of its effectiveness in the palliative care setting.

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Section: Intervention Effectscontrasting

confidence: 61%

Section: Introductionmentioning

confidence: 99%

Giving and receiving thanks: A mixed methods pilot study of a gratitude intervention for palliative patients and their carers

Bernard

Poncin

Bovet

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…This trend points to the limits of our quantitative assessment in capturing participants’ experiences, as noted by several people in interview (“your questionnaire had nothing to do with what I wrote”), suggesting that our choice of quantitative indicators was not optimal. Whilst our quantitative results are less encouraging than other gratitude intervention studies in oncology [ 15 – 17 ], the potential for comparison with this body of research remains limited insofar as our study and intervention designs differ from the latter (e.g. no control group, original gratitude intervention).…”

Section: Discussionmentioning

confidence: 62%

“…A recent randomised controlled trial with advanced cancer patients in Indonesia showed that a week-long mindful gratitude journaling intervention – i.e. daily gratitude listing and meditation on the objects of gratitude – helped patients experience less anxiety and depression and greater spiritual wellbeing than those who took part in a routine journaling intervention [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

Giving and receiving thanks: a mixed methods pilot study of a gratitude intervention for palliative patients and their carers

et al. 2023

View full text Add to dashboard Cite

Background Psychological research examining the nature and workings of gratitude has burgeoned over the past two decades. However, few studies have considered gratitude in the palliative care context. Based on an exploratory study which found that gratitude was correlated with better quality of life and less psychological distress in palliative patients, we designed and piloted a gratitude intervention where palliative patients and a carer of their choice wrote and shared a gratitude letter with each other. The aims of this study are to establish the feasibility and acceptability of our gratitude intervention and provide a preliminary assessment of its effects. Methods This pilot intervention study adopted a mixed-methods, concurrent nested, pre-post evaluation design. To assess the intervention’s effects, we employed quantitative questionnaires on quality of life, quality of relationship, psychological distress, and subjective burden, as well as semi-structured interviews. To assess feasibility, we considered patients and carers’ eligibility, participation and attrition rates, reasons for refusal to participate, appropriateness of intervention timeframe, modalities of participation, and barriers and facilitators. Acceptability was assessed through post-intervention satisfaction questionnaires. Results Thirty-nine participants completed the intervention and twenty-nine participated in interviews. We did not find any statistically significant pre/post intervention changes for patients, but found significant decrease in psychological distress for carers in terms of depression (median = 3 at T0, 1.5 at T1, p = .034) and total score (median = 13 at T0, 7.5 at T1, p = .041). Thematic analysis of interviews indicates that overall, the intervention had: (1) multiple positive outcomes for over a third of interviewees, in the form of positive emotional, cognitive, and relational effects; (2) single positive outcomes for nearly half of interviewees, who experienced emotional or cognitive effects; (3) no effect on two patients; and (4) negative emotional effects on two patients. Feasibility and acceptability indicators suggest that the intervention was well received by participants, and that it should adopt flexible modalities (e.g. writing or dictating a gratitude message) to ensure that it is feasible and adapted to individual needs and preferences. Conclusions Larger scale deployment and evaluation of the gratitude intervention, including a control group, is warranted in order to have a more reliable evaluation of its effectiveness in palliative care.

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“…To the best of our knowledge, no study has implemented a narrative journaling feature in mobile mental health apps for SCD. Journal features may provide users with an alternative method for reflection and increase self-awareness while providing additional mental health benefits [ 45 , 46 ]. Expressive writing is a well-known therapeutic intervention with both physical and psychological health benefits [ 47 ].…”

Section: Discussionmentioning

confidence: 99%

Tailoring a Digital Mental Health Program for Patients With Sickle Cell Disease: Qualitative Study

Nikolajski¹,

O'Brien²,

Nardo³

et al. 2023

JMIR Ment Health

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Background Depression and other mental health disorders are prevalent among people living with chronic health conditions. Although digital cognitive behavioral therapy (CBT) is considered an effective treatment, African American individuals are less likely to engage in and adhere to digital therapies for mental health disorders compared with White individuals. Objective The aim of this study was to understand digital CBT mental health treatment perceptions and preferences of African American individuals with sickle cell disease (SCD). Methods African American individuals with SCD from various US locations were invited to participate in a series of focus groups. Participants were introduced to a health coach–supported mental health app and then asked a series of questions about the usability and appeal of the program as well as, more generally, what would make a digital mental health program effective for them. The authors reviewed the focus group transcripts and conducted a qualitative analysis of the results. Results A total of 25 people participated in 5 focus groups. Overall, 5 primary themes emerged regarding how app content and related coaching could be modified to enhance digital CBT engagement. These themes included connection with others living with SCD, the personalization of app content and coaching, characteristics of coaches, journaling and pain tracking, and considerations for optimal engagement. Conclusions Enhancing the user experience by making digital CBT tools relevant to patient populations is critical for optimizing program engagement and its uptake. Our findings highlight potential strategies to modify and design digital CBT tools for users with SCD and may also be applicable to patients with other chronic conditions. Trial Registration ClinicalTrials.gov NCT04587661; https://clinicaltrials.gov/ct2/show/NCT04587661

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

Cited by 10 publications

References 21 publications

Giving and receiving thanks: A mixed methods pilot study of a gratitude intervention for palliative patients and their carers

Giving and receiving thanks: A mixed methods pilot study of a gratitude intervention for palliative patients and their carers

Giving and receiving thanks: a mixed methods pilot study of a gratitude intervention for palliative patients and their carers

Tailoring a Digital Mental Health Program for Patients With Sickle Cell Disease: Qualitative Study

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