Understanding the Challenge

Advanced lung cancer presents not only physical challenges but also notable psychological burdens. Death anxiety, depression, and stress can severely impact a patient’s quality of life, hindering thier ability to cope with the illness. Unmanaged, these factors can also lead to the overuse of healthcare resources.

The Intervention: A two-Pronged approach

Researchers explored a combined intervention strategy to address these psychological challenges. this approach integrates two key components:

• End-of-Life Demands Card Game (ELDCG): this game facilitates conversations about end-of-life wishes and preferences, helping patients gain a sense of control and reduce anxiety.
• Mindfulness-Based Cancer Recovery (MBCR) Program: This program incorporates mindfulness techniques to help patients manage stress, pain, and negative emotions.

The Study: Design and Methodology

A randomized controlled trial, registered as ChiCTR2400081628, evaluated the effectiveness of this combined intervention. From May 2021 to November 2021, 77 patients aged 18 and older with stage III or IV lung cancer were randomly assigned to one of two groups:

• Intervention Group (n = 38): Received ELDCG plus MBCR.
• Control Group (n = 39): Received routine health promotion.

The intervention consisted of the ELDCG, administered 1 to 3 days after enrollment, followed by the MBCR program. The MBCR program included three training sessions:

• 2 weeks of torso scanning exercises
• 2 weeks of positive breathing exercises
• 2 weeks of positive thoght meditation

The first session was conducted in person,with the subsequent two sessions performed over the phone.

Key Findings: Reduced Death Anxiety and Improved Well-being

The study’s results, published in Frontiers in Psychology, demonstrated significant benefits for patients in the intervention group. Specifically, the total and dimension scores for death anxiety were lower in the intervention group compared to the control group.

The mean death anxiety score in the intervention group was 3.16 (SD, 2.21), compared to 6.15 (SD, 2.36) in the control group (P < .001). furthermore, scores in the intervention group were lower following the intervention than before. The mean death anxiety score was 6.50 at baseline vs 3.16 after 6 weeks.

Statistically significant improvements were also observed across four dimensions:

• Emotion: Mean scores were 0.79 (SD,0.34) in the intervention group vs 2.13 (SD, 1.32) in the control group (P < .001).
• Stress and Pain: Mean scores were 0.61 (SD, 0.35) vs 1.23 (SD,0.78; P = .003).
• Time Awareness: Mean scores were 0.63 (SD, 0.36) vs 1.05 (SD,0.65; P = .013).
• Cognitive: Mean scores were 1.13 (SD, 0.56) vs 1.74 (SD, 0.68; P = .01).

Prior to the intervention, there were no significant differences between the two groups in emotion (P = .85), stress and pain (P =.06), time awareness (P = .53), and cognitive scores (P = .92).

Expert Insights

According to researchers, the combined approach effectively addresses key psychological issues. The combination of ELDCG and MBCR effectively addresses key psychological issues such as death anxiety, depression, and stress in patients with advanced lung cancer, they wrote.

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.

Researchers in Frontiers in Psychology

Study Participants: Demographics

The demographic characteristics of the participants were as follows:

• Age 18 to 44: 42.10% in the intervention group vs 41.02% in the control group.
• Education level:
  • Primary: 39.47% vs 25.64%
  • Junior School: 47.37% vs 48.72%
  • High School: 10.52% vs 17.95%
• Marital Status: 94.74% vs 92.31% were married.
• Religious Affiliation: 94.74% vs 97.44% were areligious.
• Income: 55 out of 77 enrolled patients had an income below 5000 Yuans.

Study Endpoints

The study focused on several key outcomes:

• primary Endpoint: Templer’s death anxiety score.
• Secondary Outcomes: Scores on the Hospital Anxiety and Depression Scale (HADS) and the Chinese version of the Perceived Stress Scale (CPSS).
• Exploratory Endpoint: The frequency of card selection in the ELDCG.

FAQ: Addressing Common Questions

What is the ELDCG?

The end-of-life demands card game is a tool to facilitate conversations about end-of-life wishes.

What is the MBCR program?

The mindfulness-based cancer recovery program uses mindfulness techniques to manage stress and pain.

How long was the intervention?

the intervention lasted for 6 weeks.

What were the main benefits?

Reduced death anxiety and improved emotional well-being.