Mindfulness/Activity Program May Ease Anxiety Over Death from Lung Cancer

For patients who underwent a 6-week intervention the total and dimension scores for death anxiety were lower than for patients who underwent routine health promotion alone, with a mean score of 3.16 in the investigational group vs a mean score of 6.15 in the control group.

An end-of-life demands card game (ELDCG), and mindfulness-based cancer recovery (MBCR) program assisted patients with advanced lung cancers in alleviating death anxiety and negative emotions, improving their ability to manage their disease, according to a randomized controlled trial (ChiCTR2400081628) published in Frontiers in Psychology.

Results from the trial revealed that for patients who underwent a 6-week intervention which included the use of the ELDCG combined with the MBCR program the total and dimension scores for death anxiety were lower than for patients who underwent routine health promotion alone, with a mean score of 3.16 (SD, 2.21) in the investigational group vs a mean score of6.15 (SD, 2.36) in the control group (P <.001). Furthermore, scores in the investigational group were lower following the intervention than before; the mean death anxiety score was 6.56 (SD, 2.28) at baseline vs 3.16 (SD, 2.21) after 6 weeks.

Additionally, statistically significant improvements were observed across 4 dimensions with the intervention vs standard-of-care health promotion alone: emotion, stress and pain, time awareness, and cognitive. The mean scores for emotion in respective groups were 0.79 (SD, 0.34) vs 2.13 (SD, 1.32; P < .001); mean stress and pain scores were 0.61 (SD, 0.34) vs 1.23 (SD, 0.87; P = .003); mean time awareness scores were 0.63 (SD, 0.36) vs 1.05 (SD, 0.65; P = .013); and mean cognitive scores were 1.13 (SD, 0.56) vs 1.74 (SD, 0.68; P = .01). There were no significant differences in emotion (P = .85), stress and pain (P =.06), time awareness (P = .53), and cognitive scores (P = .92) between the 2 groups prior to intervention.

“The combination of ELDCG and MBCR effectively addresses key psychological issues such as death anxiety, depression, and stress in patients with advanced lung cancer,” study lead author Xian Luo, researcher of the Department of Nursing and Neurosurgery at the Affiliated Hospital of Zunyi Medical Center in Zunyi, China, wrote in the publication with study coinvestigators. “These psychological burdens, if left unmanaged, can severely affect the patient’s quality of life, hinder their ability to cope with illness, and lead to the overuse of health care resources. By alleviating these psychological factors, the intervention not only improves the patient’s well-being but also helps optimize health care resource usage, thereby reducing the financial strain on the healthcare system.”

From May 2021 to November 2021, patients 18 years and older with pathologically or cytologically confirmed stage III or IV lung cancer were randomly assigned 1:1 to undergo ELDCG plus MBCR (n = 38) or routine health promotion (n = 39). The intervention consisted of ELDCG occurring 1 to 3 days after enrollment, followed by MBCR the day after comprising 3 training sessions. The training sessions comprised 2 weeks of torso scanning exercises, 2 weeks of positive breathing exercises, and 2 weeks of positive thought meditation; the first session of which was done in person and the 2 subsequent performed over the phone.

The primary end point of the study was Templer’s death anxiety score. Secondary outcomes included scores on the Hospital Anxiety and Depression Scale (HADS) and the Chinese version of the Perceived Stress Scale (CPSS). The frequency of card selection in the ELDCG was an exploratory end point.

In the investigational and control groups, 42.10% and 41.02% were ages 18 to 44. A total of 39.47% vs 25.64% had a primary level of education, 47.37% vs 48.72% had a junior school level of education, and 10.52% vs 17.95% had a high school level of education. Furthermore, 94.74% vs 92.31% of respective groups were married and 94.74% vs 97.44% were areligious. Fifty-five patients out of 77 enrolled had an income below 5000 Yuans.

Reference

Luo X, Miao X, Ding N, Fu Z, Wang X, Li Y, et al. Application of the end-of-life demands card game and mindfulness-based cancer recovery program for reducing negative emotion in patients with advanced lung cancer: a randomized controlled trial. Front psychol. 2025;16. doi:10.3389/fpsyg.2025.1476207