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Cited by 16Mindfulness and Compassion InterventionsCancer survivorship and careReligion, Spirituality, and Psychology

Comparison of the acceptability and benefits of two mindfulness-based interventions in women with breast or gynecologic cancer: a pilot study

Open access
Stafford, Lesley, Thomas, Naomi, Foley, Elizabeth, Judd, Fiona, Gibson, Penny, Komiti, Angela, Couper, Jeremy, Kiropoulos, Litza·2015·Supportive Care in Cancer
DOI 10.1007/s00520-014-2442-6
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Abstract

Purpose: The aim of this study was to compare the relative benefits and acceptability of two different group-based mindfulness psychotherapy interventions among women with breast and gynecologic cancer. Methods: Data from 42 women who completed an 8-week mindfulness-based cognitive therapy (MBCT) program comprising 22 contact hours were compared to data from 24 women who completed a 6-week mindfulness meditation program (MMP) comprising 9 contact hours. Distress, quality of life (QOL), and mindfulness were evaluated pre- (T1) and post-intervention (T2). ANCOVA was used to analyse the relationship between intervention type and T1 score on outcome variable change scores. Participants’ perceptions of benefit and acceptability were assessed. Results: The participants did not differ on clinical or demographic variables other than MBCT participants were more likely than MMP participants to have a past history of anxiety or depression (p =.01). Scores on distress, QOL, and mindfulness improved from T1 to T2 with medium to large effect sizes for the MMP (p =.002, d =.07; p =.001, d =.08; p =.005, d =.06, respectively) and MBCT (p <.001, d =.06; p =.008, d =.04; p <.001, d =.09, respectively) interventions. ANCOVA showed no main effect for intervention type on outcome change scores and no interaction between intervention type and respective T1 score. Distress and mindfulness scores at T1 had a main effect on respective change scores (p =.02, ηp 2 =.87; p =.01, ηp 2 =.80, respectively). Both programs were perceived as beneficial and acceptable with no differences between the intervention types. Conclusions: Within the limits of a small, non-randomized study, these findings provide preliminary support for the utility of a brief mindfulness intervention for improving distress and QOL in a heterogeneous group of women with cancer. Abbreviated interventions are less resource intensive and may be attractive to very unwell patients. © 2014, Springer-Verlag Berlin Heidelberg.

Integrity signals

Registry

Crossref · 10.1007/s00520-014-2442-6

Cites

19 of 19 references verified0 citation errors · 0 not checkable

Statistics

12 tests recomputed · 0 with the reported and recomputed p on opposite sides of .05

Claims the paper makes

3 of 18 cited sources checked · 0 supported · 0 flagged · accuracy not yet measured

  • Findingown data

    ANCOVA showed no interaction between intervention type and respective T1 score on outcome change scores.

    “and no interaction between intervention type and respective T1 score.”
    Quote in the paperSubstantial claim
  • Findingown data

    Neither intervention was significantly superior to the other in the amount of improvement observed.

    “neither intervention was shown to be significantly superior (in the statistical sense) in the amount of improvement observed.”
    Quote in the paperSubstantial claim
  • Findingown data

    There were no statistically significant differences between intervention types in participant-reported benefit/feedback.

    “There were no statistically significant differences between intervention types in this respect.”
    Quote in the paperSubstantial claim
  • Findingown data

    All women in both the MBCT and MMP intervention streams said they would recommend the program to other women with breast or gynaecologic cancer.

    “All women (100%) in both intervention streams said that they would recommend the program to other women with breast or gynaecologic cancer.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Participants' self-reported perceptions of benefit and acceptability accurately reflect the interventions' acceptability.
  • Findingown data

    Mean DASS-21 distress scores improved significantly from pre-intervention (T1) to post-intervention (T2) for MBCT participants (from 40.65 to 29.30, p=.001, d=0.6).

    “Mean DASS-21 (SD) scores changed significantly from T1 to T2 for MBCT participants from 40.65 (21.02) to 29.30 (18.71) (p=.001, d=0.6);”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Improvements from T1 to T2 in distress, QOL, and mindfulness are attributable to the mindfulness interventions rather than to passage of time, regression to the mean, or other factors.
  • Classified as probably not a substantial claim. 12
  • May combine two claims. 18
  • The quote only partly states this claim. 1

  • Classified as probably not a substantial claim.

    Premisecitation

    Diagnosis and treatment of breast and gynaecologic cancers are associated with high rates of often persistent psychological distress and ongoing challenges to quality of life.

    “Diagnosis and treatment of these cancers are associated with high rates of often persistent psychological distress and ongoing challenges to quality of life (QOL) [1,6,9,10,12].”
    Quote in the paperSubstantial claim2 of 5 sources checked
    • cites [1] Arndt V, Merx H, Stegmaier C, Ziegler H, Brenner H (2005) Persistence of restrictions in quality of life from the first to the third year after diagnosis in women with breast cancer. J Clin Oncol 23:4945–4953 source

      The Discussion reports that deficits in emotional and social functioning persist for years after breast cancer diagnosis, supporting ongoing psychological and quality-of-life challenges in that population. The paper does not address gynaecologic cancers or establish a high rate of psychological distress across both cancer groups. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
    • cites [6] Hoffman KE, McCarthy EP, Recklitis CJ, Ng AK (2009) Psychological distress in long-term survivors of adult-onset cancer: Results from a national survey. Arch Intern Med 169:1274–1281 source
    • cites [9] Ledesma D, Kumano H (2009) Mindfulness-based stress reduction and cancer: a meta-analysis. Psychooncology 18:571–579 source
    • cites [10] Mols F, Vingerhoets AJ, Coebergh JW, van de Poll-Franse LV (2005) Quality of life among long-term breast cancer survivors: a systematic review. Eur J Cancer 41:2613–2619 source

      Section 3.3 (page unavailable) reports more mild-to-moderate depressive symptoms in some long-term breast cancer survivors than in controls, alongside specific lasting quality-of-life problems. But the review covers breast cancer, not gynaecologic cancers, and says most studies found good overall quality of life; it does not establish high rates of persistent psychological distress across both cancer groups. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
    • cites [12] Shennan C, Payne S, Fenlon D (2011) What is the evidence for the use of mindfulness-based interventions in cancer care? A review. Psychooncology 20:681–697 source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    The DASS-21 has confirmed internal consistency and concurrent validity.

    “Internal consistency and concurrent validity of the DASS-21 have been confirmed [1,13].”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites [1] Arndt V, Merx H, Stegmaier C, Ziegler H, Brenner H (2005) Persistence of restrictions in quality of life from the first to the third year after diagnosis in women with breast cancer. J Clin Oncol 23:4945–4953 source

      The QOL Questionnaire section identifies the instruments used as the EORTC QLQ-C30 and BR-23, not the DASS-21. Searches for DASS-21, internal consistency, and concurrent validity found no passage in our copy addressing the DASS-21’s psychometric properties; the paper is not truncated. No page number is available for the cited section. (LLM, conf=0.76)

      Experimental — accuracy not yet measured
    • cites [13] Speca M, Carlson LE, Goody E, Angen M (2000) A randomized, wait-list controlled clinical trial: the effect of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients. Psychosom Med 62:613–622 source

  • May combine two claims.

    Findingown data

    Both MBCT and MMP interventions were associated with significant improvements in distress, QOL, and mindfulness, with medium to large effect sizes, among women with breast or gynecologic cancer.

    “As hypothesized, both interventions were associated with significant improvements in distress, QOL and mindfulness with medium to large effect sizes”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    A large proportion of this sample had high levels of education.

    “A large proportion of this sample had high levels of education, a finding that is consistent with recent reviews of mindfulness-based interventions in cancer care [9,12].”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Both the MBCT and MMP programs were perceived as beneficial by participants.

    “Both programs were perceived as beneficial and acceptable with no differences between the intervention types.”
    • Also stated in: § Acceptability and benefit of the intervention · plain
      “most women (93% in MBCT and 88% in MMP) found the overall program to be quite a bit helpful or very helpful”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Participants' self-reported perceptions of benefit and acceptability accurately reflect the interventions' acceptability.

  • May combine two claims.

    Findingown data

    There was no main effect for intervention type or an interaction between intervention type and T1 score in determining outcome.

    “There was, however, no main effect for intervention type or an interaction between intervention type and T1 score in determine outcome.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Changes from T1 to T2 for distress and mindfulness were dependent on their respective T1 scores, with greater improvement when baseline scores indicated more room for improvement.

    “Analyses showed that changes from T1 to T2 for distress and mindfulness were dependent on their respective T1 scores, indicating that there was greater improvement when there was more 'room' for improvement.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Prior to commencing the intervention, 21% of women from each subsample reported having some form of meditative practice.

    “As noted in Table 2, prior to commencing the intervention, 21% women from each subsample reported having some form of meditative practice.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Participants reported finding both programs beneficial and provided positive feedback on the interventions as a whole and their individual components.

    “Simultaneously, participants reported finding both programs beneficial and provided positive feedback of the interventions as a whole as well as their individual components.”
    • Also stated in: § Discussion · plain
      “Overall, how helpful did you find it to attend the therapy?37 (93) 21 (88)”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductnone given

    Clinical and demographic data of non-participants were not collected, so the representativeness of the sample is not known; information regarding reasons for women not being interested in the study was not recorded.

    “Furthermore, clinical and demographic data of non-participants were not collected so the representativeness of the sample is not known; and similarly, information regarding reasons for women not being interested in the study was not recorded.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    There were no significant differences between participants in the two groups in marital or educational status, age, type of cancer, living alone, current and past meditative practice, perception of physical wellbeing, receipt of adjuvant treatment, and treatment for anxiety or depression at enrolment.

    “As can be seen from this table, there were no significant differences between participants in the two groups in terms of marital or educational status, age, type of cancer, whether living alone, current and past meditative practice, perception of physical wellbeing, receipt of adjuvant treatment and treatment for anxiety or depression at enrolment.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    The two pilot interventions did not occur simultaneously but occurred separately and consecutively.

    “The two pilot interventions did not occur simultaneously but occurred separately and consecutively.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Group-based meditative practices such as MBSR and MBCT are increasingly popular in oncology settings and their effectiveness is supported by a burgeoning empirical evidence base.

    “Group-based meditative practices such as mindfulness-based stress reduction (MBSR) [8] and mindfulnessbased cognitive therapy (MBCT) [11] which employ training in mindfulness skills, are increasingly popular in oncology settings and their effectiveness is supported by a burgeoning empirical evidence base [9,12].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [9] Ledesma D, Kumano H (2009) Mindfulness-based stress reduction and cancer: a meta-analysis. Psychooncology 18:571–579 source
    • cites [12] Shennan C, Payne S, Fenlon D (2011) What is the evidence for the use of mindfulness-based interventions in cancer care? A review. Psychooncology 20:681–697 source

  • May combine two claims.

    Premisecitation

    The MBCT program was associated with significant improvements in distress, QOL, mindfulness and post-traumatic growth, and was perceived as highly beneficial and acceptable to participants.

    “The program was associated with significant improvements in distress, QOL, mindfulness and post-traumatic growth, and was perceived as highly beneficial and acceptable to participants”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [14] Stafford L, Foley E, Judd F, Gibson P, Kiropoulos L, Couper J (2013) Mindfulness-based cognitive group therapy for women with breast and gynecologic cancer: a pilot study to determine effectiveness and feasibility. Support Care Cancer 21:3009–3019 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The FACT-G has well-documented reliability and validity.

    “Reliability and validity of the FACT-G have been well documented [9].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [9] Ledesma D, Kumano H (2009) Mindfulness-based stress reduction and cancer: a meta-analysis. Psychooncology 18:571–579 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    There has been a recent call for research on simplified mindfulness interventions that are briefer and more flexible.

    “There has recently been a call for research on simplified mindfulness interventions that are briefer and more flexible [12].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [12] Shennan C, Payne S, Fenlon D (2011) What is the evidence for the use of mindfulness-based interventions in cancer care? A review. Psychooncology 20:681–697 source

  • May combine two claims.

    Study design and conductown data

    There were complete DASS-21, FACT-G and FMI data for 23 of 24 MMP participants; complete DASS-21 and FACT-G data for 40 MBCT participants; and FMI data for 38 MBCT participants.

    “There were complete DASS-21, FACT-G and FMI data for 23 of the 24 participants in the MMP group and among the MBCT group, there were complete data DASS-21 and FACT-G data for 40 participants, and for the FMI, for 38 participants.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    The shorter contact time of the MMP means it is possibly less daunting a commitment for potential participants, particularly if terminally ill or undergoing intensive treatment.

    “The shorter contact time also means the MMP is possibly less daunting a commitment for potential participants particularly if terminally ill or undergoing intensive treatment.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductreasoning

    The study was sufficiently powered to detect within-group differences but not sufficiently powered to detect small effect sizes for between-group differences.

    “While the study was sufficiently powered to detect within group differences, it was not sufficiently powered to detect small effect sizes for the between groups differences (i.e., between the two interventions).”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Best practice requirements for MBSR and MBCT facilitators include ongoing personal mindfulness practice, receiving supervision from a mindfulness teacher, and attendance at annual mindfulness retreats.

    “For MBSR and MBCT facilitators, best practice requirements include ongoing personal mindfulness practice, receiving supervision from a mindfulness teacher, and attendance at annual mindfulness retreats [7,11].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [7] Kabat-Zinn J (1990) Full catastrophe living: Using the wisdom of your body and mind to face stress, pain and illness. Delacorte, New York source
    • cites [11] Segal ZV, Williams JMG, Teasdale JD (2002) Mindfulness-based cognitive therapy for depression: a new approach to preventing relapse. Guilford Press, New York

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The FMI has acceptable psychometric properties.

    “The FMI has been found to have acceptable psychometric properties [36].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [36]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S4 (based). May combine two claims.

    Interpretationreasoning

    Abbreviated interventions are less resource intensive and may be attractive to very unwell patients.

    “Abbreviated interventions are less resource intensive and may be attractive to very unwell patients.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The sample of women who completed the programs is representative of women with breast or gynaecologic cancer who might receive such interventions.

  • May combine two claims. The quote only partly states this claim.

    Study design and conductreasoning

    The MMP facilitator did not meet all best-practice requirements for MBSR/MBCT facilitators but was nonetheless highly skilled (an experienced clinical psychologist with psycho-oncology specialization and years of mindfulness training).

    “The MMP facilitator, however, did not meet all these requirements, but was nonetheless highly skilled.”
    • Also stated in: § Discussion · plain
      “Specifically, the MMP facilitator was an experienced clinical psychologist with specialization in psycho-oncology who had received training in the application of mindfulness across a range of settings over several years.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductnone given

    The sample was highly self-selected, and it is likely that very motivated individuals who were willing to learn new skills attended the respective programs.

    “It is recognized that the sample was highly self-selected and that it is likely that very motivated individuals, who were willing to learn new skills, attended the respective programs.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    The study had a non-randomized design and a small sample size.

    “We acknowledge the limitations of this study with its non-randomized design and small sample size.”
    Quote in the paperSubstantial claim
25 of 25

  • The paper relies on this without support.

    Improvements from T1 to T2 in distress, QOL, and mindfulness are attributable to the mindfulness interventions rather than to passage of time, regression to the mean, or other factors.

    “Within the limits of a small, non-randomized study, these findings provide preliminary support for the utility of a brief mindfulness intervention for improving distress and QOL in a heterogeneous group of women with cancer.”

  • The paper relies on this without support.

    Participants' self-reported perceptions of benefit and acceptability accurately reflect the interventions' acceptability.

    “Both programs were perceived as beneficial and acceptable with no differences between the intervention types.”

  • The paper relies on this without support.

    The sample of women who completed the programs is representative of women with breast or gynaecologic cancer who might receive such interventions.

    “in a heterogeneous group of women with cancer”
3 of 3

Statistics that don’t add up

Each reported p-value recomputed from its test statistic and degrees of freedom.

  • Inconsistent p-value: t (61) =1.08, p = .34

    Minor

    The paper reports p = .34 here; recomputing from the test statistic and its degrees of freedom gives p = .284 (two-tailed). The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p = .34 · recomputed p = .284

  • Inconsistent p-value: t (59) =.33, p = .44

    Minor

    The paper reports p = .44 here; recomputing from the test statistic and its degrees of freedom gives p = .743 (two-tailed). The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p = .44 · recomputed p = .743

2 of 2

Statistics recomputed

Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.

  • Doesn’t add upt(61) = 1.08reported p = .34 · recomputed p = .284

    “t (61) =1.08, p = .34”

  • Doesn’t add upt(59) = 0.33reported p = .44 · recomputed p = .743

    “t (59) =.33, p = .44”

  • ConsistentF(34, 15) = 2.84reported p = .02 · recomputed p = .017

    “F(34,15) =2.84, p = .02”

  • ConsistentF(1, 15) = 2.13reported p = .17 · recomputed p = .165

    “F(1,15)=2.13,p = .17”

  • ConsistentF(12, 15) = 1.04reported p = .46 · recomputed p = .464

    “F(12, 15)=1.04,p = .46”

  • Consistentt(61) = 1.6reported p = .11 · recomputed p = .115

    “t (61) =1.60, p = .11”

  • ConsistentF(52, 8) = 1.18reported p = .44 · recomputed p = .434

    “F(52,8) =1.18, p = .44”

  • ConsistentF(1, 8) = 2.87reported p = .13 · recomputed p = .129

    “F(1,8) =2.87, p = .13”

  • ConsistentF(1, 8) = 0.01reported p = .94 · recomputed p = .923

    “F(1,8) =.01, p = .94”

  • ConsistentF(30, 21) = 2.82reported p = .01 · recomputed p = .008

    “F(30,21) =2.82, p = .01”

  • ConsistentF(1, 21) = 1.3reported p = .27 · recomputed p = .267

    “F (1,21)=1.30,p = .27”

  • ConsistentF(8, 21) = 1.56reported p = .2 · recomputed p = .197

    “F (8,21)=1.56,p = .20”

12 of 12

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • MMP mindfulness change has the wrong sign

    Major

    The reported MMP FMI means rise from 33.30 at T1 to 39.43 at T2. Under the stated T2-minus-T1 definition, the change is positive 6.13, not negative 6.13; this also affects the reported between-group comparison.

    Reported -6.13 · recomputed 6.13

  • Abstract understates both distress effect sizes tenfold

    Minor

    The abstract reports distress effect sizes of 0.07 for MMP and 0.06 for MBCT, whereas the results report 0.7 and 0.6, respectively.

  • Five of six sessions is not 80% attendance

    Minor

    Attending five of six MMP sessions amounts to approximately 83.3%, rather than the stated 80%.

    Reported 80 · recomputed 83.333333

  • MBCT past-meditation percentage does not match its count

    Minor

    The 12 MBCT participants listed with past meditative practice represent approximately 28.6% of the 42 completers, not 27%.

    Reported 27 · recomputed 28.571429

  • MMP tertiary-education percentage does not match its count

    Minor

    Table 2 lists 15 tertiary-educated participants out of 24 in the MMP group. That is 62.5%, not 38%.

    Reported 38 · recomputed 62.5

  • Abstract understates both quality-of-life effect sizes tenfold

    Minor

    For QOL, the abstract gives effect sizes of 0.08 for MMP and 0.04 for MBCT; the results give 0.8 and 0.4.

  • MBCT past-treatment percentage does not match its count

    Minor

    Table 2 gives 26 MBCT participants with a past history of formal treatment, out of 42 MBCT completers. That is approximately 61.9%, not 52%.

    Reported 52 · recomputed 61.904762

  • Abstract understates both mindfulness effect sizes tenfold

    Minor

    The abstract lists mindfulness effect sizes of 0.06 for MMP and 0.09 for MBCT, but the results list 0.6 and 0.9.

8 of 8

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. Australian Institute of Health and Welfare (2010) Cancer in Australia 2010: an overview. Australian Institute of Health and Welfare, Canberra

Cited by

Sorted by citations

Related

Authors
Stafford, L., Thomas, N., Foley, E., Judd, F., Gibson, P., Komiti, A., Couper, J., & Kiropoulos, L.
Affiliations
  • Royal Women's Hospital (AU)
  • The University of Melbourne (AU)
  • The Royal Melbourne Hospital (AU)
Corresponding author
Stafford, Lesley
ORCID
Venue
Supportive Care in Cancer
Publisher
Springer Science and Business Media LLC
Published
2014-10-04
Volume
23
Issue
4
Pages
1063-1071
ISSN
  • 0941-4355 (ISSN-L)
  • 1433-7339
DOI
10.1007/s00520-014-2442-6
OpenAlex
W2145286778
Cited by
16
References
16
Citations by year
2023: 2 · 2022: 2 · 2021: 1 · 2019: 2 · 2018: 1 · 2017: 4 · 2016: 2 · 2015: 2
FWCI
3.15
Type
journal article
Language
en
Update notices
correction (2015-05-29)
Open access
Licence
www.springer.com/tdm (tdm)
Locations
  • Supportive Care in Cancer (publishedVersion)
  • PubMed (publishedVersion)
  • Minerva Access (University of Melbourne) (submittedVersion)
Funders
Pratt Foundation
Topics
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Social Sciences › Health › Religion, Spirituality, and Psychology
Keywords
mindfulness-based interventions, mindfulness-based cognitive therapy, mindfulness meditation, breast cancer, gynecologic cancer, cancer patients, distress, quality of life, acceptability, perceived benefits, group therapy
MeSH terms
Adult, Aged, Anxiety Disorders, Breast Neoplasms, Depressive Disorder, Female, Genital Neoplasms, Female, Humans, Middle Aged, Patient Acceptance of Health Care, Pilot Projects, Quality of Life, Treatment Outcome, Mind-Body Therapies, Mindfulness

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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

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Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-11.

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Statistics and arithmetic are recomputed, not judged.

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