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Cited by 127Mindfulness and Compassion InterventionsCancer survivorship and careReligion, Spirituality, and Psychology

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Effectiveness of mindfulness-based interventions on anxiety, depression, and fatigue in people with lung cancer: A systematic review and meta-analysis

Li, Juan, Li, Chan, Puts, Martine, Wu, Yu-chen, Lyu, Meng-meng, Yuan, Bo, Zhang, Jing-ping·2023·International Journal of Nursing Studies
DOI 10.1016/j.ijnurstu.2023.104447
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Abstract

Background Lung cancer is one of the most common cancers and poses a physical and psychological threat to patients. Mindfulness-based interventions are emerging forms of psychotherapy that are effective in improving physical and psychological symptoms, but no review has summarized their effectiveness on anxiety, depression, and fatigue in people with lung cancer.Objectives To evaluate the effectiveness of mindfulness-based interventions in reducing anxiety, depression, and fatigue in people with lung cancer.Design Systematic review and meta-analysis.Methods We searched the PubMed, Web of Science, Embase, China Biology Medicine disc, Wanfang Data, China National Knowledge Infrastructure, and China Science and Technology Journal databases from inception to 13 April 2022. Eligible studies included randomized controlled trials of people with lung cancer receiving mindfulness-based interventions reporting on the outcomes of anxiety, depression, and fatigue. Two researchers independently reviewed the abstracts and full texts, extracted the data and assessed the risk of bias independently by using the Cochrane 'Risk of bias assessment tool'. The meta-analysis was performed by using Review Manager 5.4, and the effect size was calculated by the standardized mean difference and its 95% confidence interval.Results The systematic review included 25 studies (2420 participants), whereas the meta-analysis included 18 studies (1731 participants). Mindfulness-based interventions significantly decreased levels of anxiety [standardized mean difference = -1.15, 95% confidence interval (-1.36, -0.94), Z = 10.75, P < 0.001], depression [standardized mean difference = -1.04, 95% confidence interval (-1.60, -0.48), Z = 3.66, P < 0.001], and fatigue [standardized mean difference = -1.29, 95% confidence interval (-1.66, -0.91), Z = 6.79, P < 0.001]. The subgroup analysis indicated that programs lasting less than eight weeks in length with structured intervention components (e.g., mindfulness-based stress reduction and mindfulness-based cognitive therapy) and 45 min of daily home practice implemented in patients with advanced stage lung cancer showed better effects than programs lasting more than eight weeks in length with less structured components and more than 45 min of daily home practice implemented in patients with mixed stage lung cancer. The overall quality of the evidence was low due to the lack of allocation concealment and blinding and the high risk of bias in most studies (80%).Conclusions Mindfulness-based interventions might be effective in reducing anxiety, depression, and fatigue in people with lung cancer. However, we cannot draw definitive conclusions because the overall quality of the evidence was low. More rigorous studies are needed to confirm the effectiveness and examine which intervention components may be most effective for improved outcomes.

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Metadata

Authors
Li, J., Li, C., Puts, M., Wu, Y.-C., Lyu, M.-M., Yuan, B., & Zhang, J.-P.
Affiliations
  • Central South University (CN)
  • Guangzhou University of Chinese Medicine (CN)
  • University of Toronto (CA)
  • Yueyang Vocational Technical College (CN)
ORCID
Venue
International Journal of Nursing Studies
Publisher
Elsevier BV
Published
2023-04
Volume
140
Pages
104447
ISSN
0020-7489 (ISSN-L)
DOI
10.1016/j.ijnurstu.2023.104447
OpenAlex
W4318464475
Cited by
127
References
77
Citations by year
2026: 30 · 2025: 53 · 2024: 37 · 2023: 7
FWCI
6.41
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • International Journal of Nursing Studies (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Canada Research Chairs
  • China Scholarship Council (202106370175)
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, lung cancer, anxiety, depression, fatigue, psychological distress, mindfulness-based stress reduction, mindfulness-based cognitive therapy, advanced lung cancer, home practice, intervention duration, risk of bias, risk of bias assessment tools
MeSH terms
Anxiety, Depression, Fatigue, Humans, Lung Neoplasms, Quality of Life, Mindfulness

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