Browsing by Subject "mindfulness"

Now showing 1 - 8 of 8
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    Addressing Personal Barriers to Advance Care Planning: Qualitative Investigation of a Mindfulness-Based Intervention for Adults with Cancer and Their Family Caregivers
    (Cambridge, 2018) Cottingham, Ann H.; Beck-Coon, Kathleen; Bernat, Jannifer K.; Helft, Paul R.; Schmidt, Karen; Shields, Cleveland G.; Torke, Alexia M.; Johns, Shelley A.; Medicine, School of Medicine
    Objective Advance care planning (ACP) increases quality of life and satisfaction with care for those with cancer and their families, yet these important conversations often do not occur. Barriers include patients’ and families’ emotional responses to cancer, such as anxiety and sadness, which can lead to avoidance of discussing illness-related topics such as ACP. Interventions that address psychological barriers to ACP are needed. The purpose of this study was to explore the effects of a mindfulness intervention designed to cultivate patient and caregiver emotional and relational capacity to respond to the challenges of cancer with greater ease, potentially decreasing psychological barriers to ACP and enhancing ACP engagement. Method The Mindfully Optimizing Delivery of End-of-Life (MODEL) Care intervention provided 12 hours of experiential training to two cohorts of six to seven adults with advanced-stage cancer and their family caregivers (n = 13 dyads). Training included mindfulness practices, mindful communication skills development, and information about ACP. Patient and caregiver experiences of the MODEL Care program were assessed using semistructured interviews administered immediately postintervention and open-ended survey questions delivered immediately and at 4 weeks postintervention. Responses were analyzed using qualitative methods. Result Four salient themes were identified. Patients and caregivers reported the intervention (1) enhanced adaptive coping practices, (2) lowered emotional reactivity, (3) strengthened relationships, and (4) improved communication, including communication about their disease. Significance of results The MODEL Care intervention enhanced patient and caregiver capacity to respond to the emotional challenges that often accompany advanced cancer and decreased patient and caregiver psychological barriers to ACP.
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    Behavioral Measurement of Mindfulness: Preliminary Examination of its Validity and Change Following a Mindfulness-Based Intervention for Adults with Advanced Cancer and their Family Caregivers
    (2022-05) Lewson, Ashley B.; Mosher, Catherine E.; Johns, Shelley; Zapolski, Tamika
    Mindfulness-based interventions (MBIs) have demonstrated efficacy in reducing symptoms in survivors of early-stage cancer and have shown promise in adults with advanced cancer and their family caregivers. These interventions may be especially helpful for coping with advanced cancer because acceptance and a greater focus on present-moment experiences are central to the adjustment process. Mindfulness may be a potential mechanism underlying MBI’s health effects, yet suboptimal assessment of mindfulness hinders examination of this hypothesis. Widely used self-report measures of mindfulness require participants to have high self-awareness and comprehend a complex skill and show limited responsiveness to MBIs. Behavioral assessment of mindfulness may address the limitations of self-report measures. The goal of the current study was to obtain preliminary evidence of the validity of a behavioral measure of mindfulness, Levinson and colleagues’ breath counting task, and its responsiveness to MBI among patients and caregivers coping with advanced cancer. Fifty-five patient-caregiver dyads were recruited from a university hospital and community clinics in Indiana. Dyads were randomized to either a 6-week MBI or a usual care control condition. Measures were administered at baseline prior to intervention (week 0), at the end of the 6-week intervention period (week 6), and 1-month post-intervention (week 10). Measures included the breath counting task, self-reported mindfulness, avoidant coping, and distress. Linear mixed modeling was used to determine whether the MEANING intervention led to increased behavioral and self-reported mindfulness compared to the usual care group. Caregivers in the MEANING condition showed improved behavioral mindfulness relative to caregivers in usual care, whereas patients in both the MEANING and usual care conditions showed relatively stable behavioral mindfulness over time. Additionally, there was no evidence that the MEANING intervention impacted behavioral mindfulness to a greater extent than self-reported mindfulness. To further examine the behavioral mindfulness measure’s validity, its relations with self-reported mindfulness, avoidant coping, and distress were examined at all time points. For both patients and caregivers, correlations between behavioral and self-reported mindfulness were small or nearly zero and were not uniformly positive. In the MEANING condition, correlations showed mostly small changes over time, and in the control condition, correlations generally showed little change over time. In addition, for patients and caregivers, most correlations between behavioral mindfulness and distress and avoidant coping were approaching zero or small. Results support the feasibility of the breath counting task in adults with advanced cancer and their caregivers, but provide limited support for its validity. The task warrants further evaluation in populations coping with chronic illness.
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    Doctoral Capstone Report: Brain Breaks with the Joseph Maley Foundation
    (2021-04-16) LeGault, Marissa; Wilburn, Victoria; Department of Occupational Therapy, School of Health and Human Sciences; Maley, Vivian
    In order to address the needs of elementary school teachers and students in the Indianapolis area in the midst of the COVID-19 pandemic, the Person-Envionrment-Occupation-Performance Model of occupational therapy was utilized to develop Brain Breaks. Brain Breaks in the category of mindfulness were created to be shared with Indianapolis area schools with the goal of addressing both physical and mental health of students in the community while they adhere to social distancing guidelines. To create easily accessible and useful content for teachers, Brain Breaks were developed in the context of videos with corresponding traditional style teacher guides. Literature suggests that students engaging in mind-body activities during the day may improve attention-to-task and overall enjoyment of lessons.
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    Healing the Body and Mind: Sensory and Somatic Interventions for Interpersonal Trauma
    (2021-05-05) Nickel, Allison; Brooks, Emma; Flores, Jessica; Loeser, Madison; Richason, Hannah; Chase, Anthony; Petrenchik, Terry; Department of Occupational Therapy, School of Health and Human Sciences
    In this rapid systematic review, research literature was investigated to evaluate sensory and somatic interventions that aid in the recovery of interpersonal traumatic experiences. This review included the evaluation of creativity-based (art, dance, music), mindfulness, neurofeedback, and emerging therapy interventions (adventure, play, resilience, neurophysiological psychotherapy). Many individuals who have been exposed to one or more traumatic events will experience a variety of side effects or consequences that will impact the rest of their lives. Survivors often experience imbalances in their psychological as well as their physical wellbeing. These imbalances are often presented in different aspects of life as well as in various parts of the body. Yet, there is little research to evaluate the effectiveness of interventions that are sensory and somatic based. The majority of our overall review indicate that there is moderate to strong evidence to support sensory and somatic based interventions used to aid in the recovery of those who have experienced an interpersonal traumatic event.
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    Mindfulness Training Supports Quality of Life and Advance Care Planning in Adults With Metastatic Cancer and Their Caregivers: Results of a Pilot Study
    (Sage, 2020-02) Johns, Shelley A.; Beck-Coon, Kathleen; Stutz, Patrick V.; Talib, Tasneem L.; Chinh, Kelly; Cottingham, Ann H.; Schmidt, Karen; Shields, Cleveland; Stout, Madison E.; Stump, Timothy E.; Monahan, Patrick O.; Torke, Alexia M.; Helft, Paul R.; Medicine, School of Medicine
    Background: Emotional distress often causes patients with cancer and their family caregivers (FCGs) to avoid end-of-life discussions and advance care planning (ACP), which may undermine quality of life (QoL). Most ACP interventions fail to address emotional barriers that impede timely ACP. Aim: We assessed feasibility, acceptability, and preliminary effects of a mindfulness-based intervention to facilitate ACP for adults with advanced-stage cancer and their FCGs. Design: A single-arm pilot was conducted to assess the impact of a 6-week group mindfulness intervention on ACP behaviors (patients only), QoL, family communication, avoidant coping, distress, and other outcomes from baseline (T1) to post-intervention (T2) and 1 month later (T3). Participants: Eligible patients had advanced-stage solid malignancies, limited ACP engagement, and an FCG willing to participate. Thirteen dyads (N = 26 participants) enrolled at an academic cancer center in the United States. Results: Of eligible patients, 59.1% enrolled. Attendance (70.8% across 6 sessions) and retention (84.6% for patients; 92.3% for FCGs) through T3 were acceptable. Over 90% of completers reported high intervention satisfaction. From T1 to T3, patient engagement more than doubled in each of 3 ACP behaviors assessed. Patients reported large significant decreases in distress at T2 and T3. Family caregivers reported large significant improvements in QoL and family communication at T2 and T3. Both patients and FCGs reported notable reductions in sleep disturbance and avoidant coping at T3. Conclusions: The mindfulness intervention was feasible and acceptable and supported improvements in ACP and associated outcomes for patients and FCGs. A randomized trial of mindfulness training for ACP is warranted.
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    Practicing Yoga and Mindfulness Strategies with Students Who are Visually Impaired
    (2022-05-02) Stone, Rianne; Wasmuth, Sally; Department of Occupational Therapy, School of Health and Human Sciences; Garvey, Elizabeth
    Students with visual impairment often have limitations with physical and self-regulation abilities. Participating in yoga and mindfulness can improve physical and mental health by decreasing stress and improving mood and well-being. This capstone project took place at a school for students who are visually impaired, many of whom have difficulty with mobility and body awareness, tend toward being sedentary, and would benefit from strategies for managing stress and anxiety. This project’s purpose was to develop and implement a yoga and mindfulness program with and for the students to improve their body awareness and self-regulation, assess the program’s impact on participants’ classroom performance, evaluate the participants’ program experience, analyze facilitators and barriers to program implementation, and explore program sustainability. Yoga participants included 77 middle and high school students and students from 2nd, 4th, and 5th grades. Nine middle school students also participated in a mindfulness practice during their science or math class. The participants’ experience and the program’s implementation were evaluated with qualitative data collection methods including field notes, participant observation, open-ended interviews, and focus groups. Students positively received yoga, with 84% reporting they enjoyed it. Students described benefits including improved mobility, math participation, and mood. The mindfulness practice was appreciated by 56% of the participating students. Those students reported mindfulness helped with focus and behavior. Faculty noted positive benefits to participating students including increased focus and behavior in class, improved understanding of and ability to engage in yoga activities, and acquiring strategies for classroom stress and anxiety management.
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    Psychological processes and symptom outcomes in cancer survivors following a mindfulness-based stress reduction intervention
    (2017-07) Chinh, Kelly; Mosher, Catherine E.; McGrew, John; Rand, Kevin L.
    Mindfulness-based interventions targeting psychological and physical symptoms in cancer survivors have been shown to be efficacious. However, little is known about theory-based psychological processes through which mindfulness-based interventions may decrease symptoms. The present study is a secondary analysis of data from a mindfulness-based stress reduction (MBSR) pilot trial targeting cancer-related fatigue (CRF) in cancer survivors. Thirty-five persistently fatigued cancer survivors were recruited from a university hospital and various community clinics in Indianapolis, Indiana. Participants were randomized to either a 7-week MBSR intervention for CRF or a waitlist control (WC) condition. Measures were administered at pre-intervention, post-intervention, and 1-month follow-up and included levels of mindfulness, acceptance, and self-compassion as well as the symptom outcomes of fatigue interference, sleep disturbance, and distress. I hypothesized that MBSR would lead to increased levels of five facets of mindfulness (i.e., observing, describing, acting with awareness, nonjudging of inner experience, nonreactivity to inner experience), self-compassion, and acceptance as compared to the WC condition. Using a linear mixed modeling approach, significant group by time interactions were only found for observing, acting with awareness, nonjudging, and self-compassion, such that the MBSR group showed steady increases in these processes over time, whereas the WC group’s scores remained relatively stable. In addition, I examined whether positive changes in the five facets of mindfulness were associated with reductions in the three symptoms using multiple linear regression. This hypothesis was partially supported; acting with awareness was the only facet of mindfulness to show a modest association with a decrease in fatigue, but this result fell short of statistical significance. In addition, decreased sleep disturbance was predicted by increases in acting with awareness and nonjudging, while decreased distress was predicted by increases in observing, acting with awareness, nonjudging, and nonreactivity. Results point to specific psychological processes that may be targeted to maximize the efficacy of future MBSR interventions for cancer survivors.
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    Randomized Controlled Pilot Trial of Mindfulness-Based Stress Reduction for Breast and Colorectal Cancer Survivors: Effects on Cancer-Related Cognitive Impairment
    (Springer, 2016-06) Johns, Shelley A.; Von Ah, Diane; Brown, Linda F.; Beck-Coon, Kathleen; Talib, Tasneem L.; Alyea, Jennifer M.; Monahan, Patrick O.; Tong, Yan; Wilhelm, Laura; Giesler, R. Brian; Department of Medicine, Indiana University School of Medicine
    Purpose Cancer-related cognitive impairment (CRCI) is a common, fatigue-related symptom that disrupts cancer survivors’ quality of life. Few interventions for CRCI exist. As part of a randomized pilot study targeting cancer-related fatigue, the effects of mindfulness-based stress reduction (MBSR) on survivors’ cognitive outcomes were investigated. Methods Breast and colorectal cancer survivors (n = 71) with moderate-to-severe fatigue were randomized to MBSR (n = 35) or a fatigue education and support (ES; n = 36) condition. The Attentional Function Index (AFI) and the Stroop test were used to assess survivors’ cognitive function at baseline (T1), after the 8-week intervention period (T2), and 6 months later (T3) using intent-to-treat analysis. Mediation analyses were performed to explore mechanisms of intervention effects on cognitive functioning. Results MBSR participants reported significantly greater improvement on the AFI total score compared to ES participants at T2 (d = 0.83, p = 0.001) and T3 (d = 0.55, p = 0.021). MBSR also significantly outperformed ES on most AFI subscales, although both groups improved over time. MBSR produced greater Stroop accuracy rates relative to ES at T2 (r = 0.340, p = 0.005) and T3 (r = 0.280, p = 0.030), with improved accuracy over time only for the MBSR group. There were no significant differences in Stroop reaction time between groups. Improvements in mindfulness mediated the effect of group (e.g., MBSR vs. ES) on AFI total score at T2 and T3. Conclusions Additional randomized trials with more comprehensive cognitive measures are warranted to definitively assess the efficacy of MBSR for CRCI. Implications for Cancer Survivors This pilot study has important implications for all cancer survivors as it is the first published trial to show that MBSR offers robust and durable improvements in CRCI.