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Mindfulness in informal caregivers of palliative patients

Published online by Cambridge University Press:  17 June 2013

Monika Kögler
Affiliation:
Interdisciplinary Center for Palliative Medicine, Ludwig-Maximilians-University, Munich, Germany
Monika Brandstätter
Affiliation:
Interdisciplinary Center for Palliative Medicine, Ludwig-Maximilians-University, Munich, Germany
Gian Domenico Borasio
Affiliation:
Centre Hospitalier Universitaire Vaudois, Service de Soins Palliatifs, University of Lausanne, Lausanne, Switzerland
Veronika Fensterer
Affiliation:
Statistical Consulting Unit, Department of Statistics, Ludwig-Maximilians-University, Munich, Germany
Helmut Küchenhoff
Affiliation:
Statistical Consulting Unit, Department of Statistics, Ludwig-Maximilians-University, Munich, Germany
Martin Johannes Fegg*
Affiliation:
Interdisciplinary Center for Palliative Medicine, Ludwig-Maximilians-University, Munich, Germany
*
Address correspondence and reprint requests to: Martin Fegg, Marchioninistr. 15, 81377 Munich, Germany. E-mail: [email protected]

Abstract

Objectives:

Mindfulness is a concept of growing impact on psychotherapy and has been shown to be effective for stress reduction and to improve psychological well-being. Existential Behavioural Therapy (EBT) was developed to support relatives of palliative care (PC) patients to cope with their situation during caregiving and bereavement. Mindfulness training was a core element of the intervention.

We investigated the relationship between mindfulness, mental distress, and psychological well-being in informal caregivers, and evaluated if the effects of the intervention were mediated by mindfulness.

Methods:

Relatives of PC inpatients took part in a randomized-controlled EBT trial and completed the Cognitive and Affective Mindfulness Scale-Revised, items from the Five Facets of Mindfulness as well as the Brief Symptom Inventory, the Satisfaction with Life Scale, the WHOQOL-BREF, a numerical rating scale on quality of life (range 0–10), and the Schedule for Meaning in Life Evaluation at pre- and post-intervention, and a 3- and 12-months follow-up.

Results:

One-hundred-and-thirty carers were included, most of them (71.6%) recently being bereaved at the beginning of the intervention. High correlations between mindfulness and mental distress (r = −0.51, p < 0.001) as well as life satisfaction (r = 0.52, p < 0.001) were found. Mindfulness was a significant predictor of improvement in psychological distress, meaning in life and quality of life three months after the intervention. The EBT effects were partly mediated by mindfulness.

Significance of results:

Mindfulness seems to be a promising concept in supporting informal caregivers of PC patients. Further research is needed to identify the required format and intensity of mindfulness practice necessary for improvement.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2013 

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References

REFERENCES

Angermeyer, M.C., Kilian, R. & Matschinger, H. (2000). WHOQOL-100 und WHOQOL-BREF (WHOQOL-100 and WHOQOL-BREF). Handbuch für die deutschsprachige Version der WHO Instrumente zur Erfassung von Lebensqualität (Handbook for the German language version of the WHO Quality of Life Instruments). Göttingen: Hogrefe.Google Scholar
Baer, R. (2003). Mindfulness training as a clinical intervention: a conceptual and empirical review. Clinical Psychology: Science and Practice, 10, 125143.Google Scholar
Baer, R.-A., Smith, G.-T. & Allen, K.-B. (2004). Assessment of mindfulness by self-report: The Kentucky inventory of mindfulness skills. Assessment, 11, 191206.Google Scholar
Baer, R.-A., Smith, G.-T., Hopkins, J., et al. (2006). Using self-report assessment methods to explore facets of mindfulness. Assessment, 13, 2745.Google Scholar
Brown, K.-W. & Ryan, R.-M. (2003). The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84, 822848.Google Scholar
Carmody, J. & Baer, R.A. (2009). How long does a mindfulness-based stress reduction program need to be? A review of class contact hours and effect sizes for psychological distress. Journal of clinical psychology, 65, 627638.Google Scholar
Chentsova-Dutton, Y., Shucter, S., Hutchin, S., et al. (2002). Depression and grief reactions in hospice caregivers: From pre-death to 1 year afterwards. Journal of Affective Disorders, 69, 5360.Google Scholar
Chiesa, A. & Malinowski, P. (2011). Mindfulness-based approaches: Are they all the same? Journal of Clinical Psychology, 67, 404424.Google Scholar
Diener, E., Emmons, R.A., Larsen, R.J., et al. (1985). The satisfaction with life scale. Journal of Personality Assessment, 49, 7175.Google Scholar
Fegg, M., Brandstätter, M., Kögler, M., et al. (2013). Existential behavioural therapy for informal caregivers of palliative patients: A randomised controlled trial. Psycho-Oncology doi:10.1002/pon.3260.Google Scholar
Fegg, M., Kramer, M., L'hoste, S., et al. (2008). The schedule for meaning in life evaluation (SMiLE): Validation of a new instrument for meaning-in-life research. Journal of Pain and Symptom Management, 4, 356363.Google Scholar
Feldman, G., Hayes, A., Kumar, S., et al. (2007). Mindfulness and emotion regulation: The development and initial validation of the cognitive and affective mindfulness scale-revised (CAMS-R). Journal of Psychopathology and Behavioral Assessment, 29, 177190.CrossRefGoogle Scholar
Franke, G. (2000). Brief Symptom Inventory von Derogatis (BSI). Kurzform der SCL-90-R (Brief symptom Inventory (BSI) by Derogatis. Short form of the SCL-90-R). Göttingen: Hogrefe Testzentrale.Google Scholar
Grossman, P., Niemann, L., Schmidt, S., et al. (2004). Mindfulness-based stress reduction and health benefits: A meta-analysis. Journal of Psychosomatic Research, 57, 3543.Google Scholar
Hayes, S.C., Luoma, J., Bond, F., et al. (2006). Acceptance and commitment therapy: Model, processes and outcomes. Behaviour Research and Therapy, 44, 125.Google Scholar
Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: Past, present, and future. Clinical Psychology: Science and Practice, 10, 144156.Google Scholar
Kang, H.-Y. & Yoo, Y.-S. (2007). Effects of a bereavement intervention program in middle-aged widows in Korea. Archives of Psychiatric Nursing, 21, 132140.Google Scholar
Kissane, D., McKenzie, M., McKenzie, D., et al. (2003). Psychosocial morbidity associated with patterns of family functioning in palliative care: Baseline data from the Family focused grief therapy controlled trial. Palliative Medicine, 17, 527537.Google Scholar
Kögler, M., Brandl, J., Brandstätter, M., et al. (submitted). “Determinants of the effect of Existential Behavioural Therapy for bereaved partners: A qualitative study. Journal of Palliative Medicine.Google Scholar
Kumar, S.M. (2005). Grieving Mindfully: A Compassionate and Spiritual Guide to Coping with Loss, Oakland: New Harbinger Publications.Google Scholar
Nyklicek, I. & Kuijpers, K. (2008). Effects of mindfulness-based stress reduction intervention on psychological well-being and quality of life: Is increased mindfulness indeed the mechanism? Annals of Behavioral Medicine, 35, 331340.Google Scholar
Nyklicek, I., van Son, J. & Pouwer, F. (2010). Two recently published meta-analyses on the effectiveness of mindfulness-based interventions: What should the reader make of it? Journal of Psychosomatic Research, 69, 613614.Google Scholar
Oken, B., Fonareva, I., Haas, M., et al. (2010). Pilot controlled trial of mindfulness meditation and education for dementia caregivers. Journal of Alternative & Complementary Medicine, 16, 10311038.Google Scholar
Orzech, K.M., Shapiro, S.L., Brown, K.W., et al. (2009). Intensive mindfulness training-related changes in cognitive and emotional experience. The Journal of Positive Psychology, 4, 212222.Google Scholar
Robins, C.J. & Chapman, A.L. (2004). Dialectical behavior therapy: Current status, recent developments, and future directions. Journal of Personality Disorders, 18, 7389.Google Scholar
Shapiro, S., Bootzin, R., Figueredo, A., et al. (2003). The efficacy of mindfulness-based stress reduction in the treatment of sleep disturbance in women with breast cancer: An exploratory study. Journal of Psychosomatic Research, 54, 8591.Google Scholar
Shapiro, S.L., Carlson, L.E., Astin, J.A., et al. (2006). Mechanisms of mindfulness. Journal of Clinical Psychology, 62, 373386.Google Scholar
Teasdale, J.D., Segal, Z.V., Williams, J.M.G., et al. (2000). Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology, 68, 615623.Google Scholar
Toneatto, T. & Nguyen, L. (2007). Does mindfulness meditation improve anxiety and mood symptoms? A review of the controlled research. Canadian Journal of Psychiatry, 52, 260266.Google Scholar
Vickers, A. & Altman, D. (2001). Analysing controlled trials with baseline and follow up measurements. BMJ, 323, 11231124.Google Scholar
Waelde, L.C., Thompson, L. & Gallagher-Thompson, D. (2004). A pilot study of a yoga and meditation intervention for dementia caregiver stress. Journal of Clinical Psychology, 60, 677687.Google Scholar